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This is VAERS ID 1439051

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1439051
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-04-17
Onset:2021-05-06
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX0893 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-06
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:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes (treated for diabetes)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ITPFIZER INC2021759295

Write-up: died on 06May2021 of cardiac arrest; This is a spontaneous report from a contactable consumer downloaded from the Regulatory Authority-WEB, the regulatory authority report number is IT-MINISAL02-745997. A 92-year-old female patient received bnt162b2 (COMIRNATY, Batch/Lot Number: EX0893), intramuscular on 17Apr2021 as dose 1, single for covid-19 immunization. Medical history included diabetes from an unknown date and unknown if ongoing, treated for diabetes. The patient''s concomitant medications were not reported. The patient experienced death on 06May2021. The patient died on 06May2021 of cardiac arrest. It was not reported if an autopsy was performed. Impact on quality of life (10/10). No treatment received. Reporters comment: The person received the Pfizer vaccine on 17Apr2021. He was being treated for diabetes but never suffered from heart problems. She died on 06May2021 of cardiac arrest. No follow-up attempts are possible. No further information is expected.; Reporter''s Comments: The person received the Pfizer vaccine on 17Apr2021. He was being treated for diabetes but never suffered from heart problems. She died on 06May2021 of cardiac arrest.; Reported Cause(s) of Death: cardiac arrest

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