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This is VAERS ID 955790

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 955790
VAERS Form:2
Age:89.0
Sex:Female
Location:Foreign
Vaccinated:2021-01-13
Onset:2021-01-13
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-13
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 INC2021032465

Write-up: died apprioximately one hour later; This is a spontaneous report from a non-contactable other healthcare professional (HCP) from a lay media. An 89-year-old female patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 13Jan2021 at 12:00 at single dose for Covid-19 immunisation. The relevant medical history and concomitant medications were not reported. Afterwards she was for 15 minutes under medical observation. At that time there were no visible allergy-typical symptoms. The patient was generally fit and at the timepoint of the vaccination well oriented. At 12:45 a situation took place that the patient must be resuscitated. However, she died apprioximately one hour later on 13Jan2021. Autopsy was ordered. The outcome of the event was fatal. Information on the lot/ batch number has been requested.; Sender''s Comments: Current information is very limited for full assessment. The advanced old patient died one hour following the vaccine use; further information such as complete medical history, concomitant medications, concurrent illness and event term details especially death cause and autopsy results are needed for meaningful evaluation. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: unknown cause of death

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=955790&WAYBACKHISTORY=ON

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