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This is VAERS ID 1338213

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1338213
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:2021-05-09
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: Death

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 INC2021559013

Write-up: Adverse event following immunisation with outcome fatal; This is a spontaneous report from a contactable other health professional via the regulatory authority. Regulatory authority report number is 550219. A 79-year-old male patient received bnt162b2 (COMIRNATY, solution for injection, lot/batch number and expiration date not reported), via an unspecified route of administration on an unspecified date at single doses for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced adverse event following immunization on 09May2021 with outcome of fatal. The Medicine/Onset Time in Days with event ''adverse event following immunization'' reported as 5 days. The patient died in 2021. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Adverse event following immunisation with outcome fatal

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