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This is VAERS ID 978490

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 978490
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Drug ineffective, Malaise, Pyrexia, Suspected COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-23
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: Medical History/Concurrent Conditions: Hypertension (treated with medications)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ILPFIZER INC2021067523

Write-up: a suspicion that he had corona; a suspicion that he had corona; he raised fever; he did not feel well; This is a spontaneous report from a contactable consumer reported for his/her father. A male patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number and expiration date not provided), via an unspecified route of administration on an unspecified date in Jan2021 (reported as 3 weeks ago) at single dose for covid-19 immunisation. Medical history included hypertension treated with medications. The patient''s concomitant medications were not reported. The patient who was generally healthy was vaccinated 3 weeks ago on an unspecified date in Jan2021 and he was supposed to receive the 2nd vaccine dose today on 23Jan2021. This morning on 23Jan2021, he passed away after he did not feel well from Jan2021 for 3 days and yesterday on 22Jan2021 he raised fever. The cause of death is unknown but there is a suspicion that he had corona. The patient died on 23Jan2021. It was not reported if an autopsy was performed. The outcome of the events was fatal. Information about lot/batch number has been requested.; Reported Cause(s) of Death: a suspicion that he had corona

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