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This is VAERS ID 1338206

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1338206
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Death, Vaccination failure, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-05
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Test Date: 20210312; Test Name: COVID-19; Test Result: Positive
CDC 'Split Type': FRPFIZER INC2021527943

Write-up: SARS-CoV-2 infection; Vaccination failure; death; This is a spontaneous report from a contactable pharmacist reporting for a patient downloaded from the Agency Regulatory Authority-WEB FR-AFSSAPS-GR20211204, Safety Report Unique Identifier FR-AFSSAPS-2021037815. An 83-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 10Feb2021 (Batch/Lot Number: EJ6788) as 2ND DOSE, SINGLE; and dose 1 intramuscular on 20Jan2021 (Batch/Lot Number: EJ6788) as 1ST DOSE, SINGLE for covid-19 immunisation, age at vaccination unknown. The patient medical history and concomitant medications were not reported. Patient was a symptomatic COVID-19-positive case (12Mar2021). She was a female resident of a residential care home having had the complete vaccine round with COMIRNATY (2 injections, one on 20Jan2021 and one on 10Feb2021, lot EJ6788). Onset of symptoms was on 12Mar2021. Differential diagnosis was a non-identified strain. Patient was admitted to hospital on 15Mar2021 with oxygen treatment. Outcome of the event SARS-CoV-2 infection and Vaccination failure was not recovered. The resident died, from a different primary cause, on 05Apr2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected. Lot number has been received.; Reported Cause(s) of Death: died of different primary cause

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