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This is VAERS ID 960066

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 960066
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-11
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6796 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-01
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 INC2021033073

Write-up: exitus letalisin temporary association with vaccination; This is a spontaneous report from a contactable other healthcare professional received via local supervisory health authority. An 86-year-old female patient received her first dose of bnt162b2 (COMIRNATY, lot number EJ6796), via an unspecified route of administration on left arm on 11Jan2021 at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient was vaccinated with Comirnaty on 11Jan2021, after about 36 hours she died (exitus letalisin temporary association with vaccination). The patient died in Jan2021. It was not reported if an autopsy was performed. Autopsy for clarification of cause of death will be carried out.; Sender''s Comments: The event death is assessed as related to BNT162b2 vaccine and documented as such in the global safety database until sufficient information is available to allow an unrelated causality assessment. 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: died

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