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This is VAERS ID 1433123

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1433123
VAERS Form:2
Age:87.0
Sex:Female
Location:Foreign
Vaccinated:2021-04-01
Onset:2021-04-01
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Sudden cardiac death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arterial hypertension; Arterial occlusive disease; Dementia; Diabetes mellitus (badly adjusted)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021752720

Write-up: Sudden cardiac death; Dyspnoea; This is a spontaneous report from a non-contactable physician downloaded from the Regulatory Authority-WEB, Safety Report Unique Identifier DE-PEI-202100101095. A 87-years-old female patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 01Apr2021 (Batch/Lot Number: Unknown) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. Medical history included ongoing Arterial hypertension, ongoing Arterial occlusive disease, ongoing Diabetes mellitus, ongoing Dementia. The patient''s concomitant medications were not reported. On 01Apr2021 the patient experienced Dyspnoea, Sudden cardiac death. The patient died on an unspecified date. An autopsy was not performed. Outcome of events was fatal. This report is serious as death. Relatedness of drug to reaction(s)/event(s) was Unclassifiable. No follow-up attempts are possible. No further information expected. Information on batch/lot number cannot be obtained.; Reported Cause(s) of Death: Suspected acute myocardial infarction

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