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This is VAERS ID 1440332

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440332
VAERS Form:2
Age:91.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-02
Onset:2021-06-10
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1D013A / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-10
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': DEPFIZER INC2021728715

Write-up: Unknown cause of death; This is a spontaneous report downloaded from the Regulatory Authority-WEB number DE-PEI-202100100827 from a non-contactable physician. A 91-year-old female patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on 02Jun2021 (Batch/Lot Number: 1D013A) (at the age of 91 years) as DOSE 2, 0.3 ML SINGLE for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Patient previously received the first dose of bnt162b2 (COMIRNATY), on 05May2021 (Batch/Lot Number: Unknown) (at the age of 90 years) as DOSE 1, 0.3 ML SINGLE for COVID-19 immunisation. This report is serious for death. On 10Jun2021 the patient experienced Unknown cause of death. The patient''s outcome was: fatal for Unknown cause of death. It was not reported if an autopsy was performed. Event assessment: Comirnaty/ event/Regulatory Authority/Result of Assessment: D. Unclassifiable. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death

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