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This is VAERS ID 1338069

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1338069
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-04-27
Onset:2021-05-10
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-10
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: Non-smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESPFIZER INC2021553656

Write-up: Sudden death; This is a spontaneous report from a contactable consumer or other non hcp downloaded from the regulatory authority, ES-AEMPS-861158. A 64-year-old male patient received BNT162b2 (COMIRNATY, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration in arm on 27Apr2021 as 1st dose single for COVID-19 immunization. Patient medical history included that the patient had no known pathologies and was a non-smoker, athlete and concomitant medications were not reported. A family member reported that the patient had not been infected by COVID-19. On 10May2021 (as reported) Death occurred at night, two weeks after vaccination. It was classified as cardiorespiratory arrest. The judge has denied the autopsy request, despite the fact that the family doctor requested it, on suspicion that vaccination may have played some role in the outcome. The outcome of the event was fatal. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Cardio-respiratory arrest

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