National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 990151

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 990151
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-18
Onset:2021-01-18
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-18
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: Arteritis; Hypertension; Non-insulin-dependent diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FRPFIZER INC2021073665

Write-up: Cardiac arrest; This is a spontaneous report from a contactable other Healthcare Professional (HCP) from the Medicines Agency (MA) Regulatory Authority -WEB FR-AFSSAPS-CN20210070. An 89-year-old female patient living in a nursing house received the first dose of BNT162B2 (COMIRNATY, Lot # EM0477), intramuscular, on 18Jan2021 at single dose for COVID-19 immunisation. Medical history included arteritis, hypertension, non-insulin-dependent type 2 diabetes. The patient had not presented covid-19 (but not tested). Seven hours after administration of the vaccine, the patient suffered cardiac arrest. Death occurs 58 minutes later despite attempts at resuscitation on 18Jan2021. According to the declarer this effect was completely unexpected. An autopsy was not performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Cardiac arrest

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=990151&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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