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This is VAERS ID 1439286

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First Appeared on 7/2/2021

VAERS ID: 1439286
VAERS Form:2
Age:91.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-22
Onset:2021-06-22
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Acute myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-22
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': JPPFIZER INC2021763996

Write-up: This is a spontaneous report from a contactable physician received via COVID-19 Adverse Event Self-Reporting and the same contactable physician who conducted autopsy. Regulatory authority report number is v21115859. The patient was a non-pregnant 91-year-old female. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. It was not reported whether the patient received any other medications within 2 weeks of vaccination. It was unknown whether the patient was diagnosed with COVID-19 prior to vaccination. Medical history was not reported. On 22Jun2021 (the day of vaccination), the patient received a single dose of BNT162b2 (COMIRNATY, Solution for injection, lot number and expiration date were not reported), dose 1 via an unspecified route of administration for COVID-19 immunization at the age of 91-year-old. On 22Jun2021 (on the same day of the vaccination), the patient experienced acute myocardial infarction. The outcome of the event was fatal (death). It was unknown whether the patient received a treatment or not for the event. An autopsy was not performed. It was unknown whether the patient has been tested for COVID-19 since the vaccination. The reporting physician classified the event as serious (death) and the reporter stated the event result in death. The course of the event was as follows: On 22Jun2021 at 21:00 (estimated) the patient experienced sudden death while taking a bath. The reporting physician assessed that the causality between the event and BNT162b2 as unassessable. Other possible cause of the event such as any other diseases was acute myocardial infarction. The reporting physician commented as follows: The patient died on the same day of the vaccination.; Reporter''s Comments: The patient died on the same day of the vaccination.; Reported Cause(s) of Death: Acute myocardial infarction

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