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This is VAERS ID 990298

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 990298
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-15
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1484 / 1 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ITPFIZER INC2021068116

Write-up: Dyspnea; This is a spontaneous report from a contactable physician downloaded from the regulatory authority. The regulatory authority report number is IT-MINISAL02-656016. A 91-year-old female patient received BNT162B2 (COMIRNATY; Lot number EL1484, expiration date 30Apr2021), intramuscular into the left arm on 15Jan2021, at 18:00 as single dose covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced dyspnea on 16Jan2021, which was serious as it lead to death. The patient died on 18Jan2021. It was not reported if an autopsy was performed. Sender''s comment: additional information requested from reporter including discharge report.; Reported Cause(s) of Death: Dyspnea

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