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This is VAERS ID 1583476

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/20/2021

VAERS ID: 1583476
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-31
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Fall, Lethargy, Syncope, General physical health deterioration

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AUPFIZER INC202101033745

Write-up: Fall; General physical health deterioration; Lethargy; Syncope; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 598893. A 98-year-old female patient received bnt162b2 (COMIRNATY, Solution for injection), dose 1 via an unspecified route of administration on 31Mar2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced fall (death) on 04Apr2021, general physical health deterioration (death) on 04Apr2021 , lethargy (death) on 04Apr2021 , syncope (death) on 04Apr2021. The patient died in 2021. It was not reported if an autopsy was performed. The outcome of events was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Fall; General physical health deterioration; Lethargy; Syncope

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