National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 1467342

Government Disclaimer on use of this data

Case Details

VAERS ID: 1467342 (history)  
Form: Version 2.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Cardiopulmonary failure
SMQs:, Cardiac failure (narrow), Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dementia; Internal carotid artery stenosis (ACI-Stenosis); Intervertebral disc protrusion (discus protrusion L4/L5)
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: ATPFIZER INC2021804062

Write-up: Cardiopulmonary insufficiency; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority (RA)-WEB, regulatory authority number AT-BASGAGES-2021-33611. An 89-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 18Jun2021 (Lot Number: FD0168) as single dose for COVID-19 immunisation. Medical history included ongoing carotid artery stenosis (ACI-Stenosis), ongoing dementia dementia, ongoing intervertebral disc protrusion (discus protrusion L4/L5). Concomitant medications were not reported. Previously the patient received the first dose of COMIRNATY (Lot # EY7015) on 07May2021 for COVID-19 immunisation. The patient experienced cardiopulmonary insufficiency (medically significant) on 24Jun2021. The patient died on 24Jun2021 from cardiopulmonary insufficiency. An autopsy was not performed. Sender''s comment: comment: No further information available. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Cardiorespiratory insufficiency

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166