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This is VAERS ID 1336363

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1336363
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Agitation, Dyspnoea, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': AUPFIZER INC2021562785

Write-up: Agitation; Dyspnoea; Myocardial infarction; This is a spontaneous report from a contactable other health professional via a regulatory authority. Regulatory authority report number is 553078. An 83-year-old female patient received BNT162B2 (COMIRNATY, solution for injection, Lot number), via an unspecified route of administration, on unknown date at single dose for COVID-19 immunisation. No relevant medical history and concomitant medications were provided. On unknown date, the patient developed agitation, dyspnoea and myocardial infarction. The events caused patient''s death on unknown date. It was unknown if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Agitation; Dyspnoea; Myocardial infarction

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