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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EW8904 / UNK||- / -|
Administered by: Other Purchased by: ??
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Preexisting Conditions: Medical History/Concurrent Conditions: Deep vein thrombosis leg
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021544649
Write-up: Unknown cause of death; This is a spontaneous report from a non-contactable physician downloaded from the Regulatory Authority-WEB DE-PEI-202100062953. An 80-year-old male patient received BNT162B2 (COMIRNATY), via an unspecified route of administration at the age of 80-year-old on 10Apr2021 (batch/Lot Number: EW8904) as single dose for covid-19 immunisation. Medical history included deep vein thrombosis leg. The patient''s concomitant medications were not reported. The patient experienced unknown cause of death on 14Apr2021. The patient died on 14Apr2021. An autopsy was not performed. The reporter''s assessment on the causal relationship between the suspect product Comirnaty and the event death was unclassifiable. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death
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