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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||FA5831 / 1||LA / OT|
Administered by: Other Purchased by: ??
Symptoms: Cardio-respiratory arrest
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
Other Medications: LEVETIRACETAM; PHENOBARBITAL; LANSOPRAZOLE
Current Illness: Paralytic disability
Diagnostic Lab Data:
CDC 'Split Type': ITPFIZER INC2021560707
Write-up: Cardio-respiratory arrest; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB IT-MINISAL02-728694 A 65-year-old female patient received the first dose of BNT162B2 (COMIRNATY, lot number: FA5831 and expiration date: 31Aug2021), via intramuscular, in arm left, on 10May2021 12:10, at 0.3 mL single dose, for COVID-19 immunization. Medical history included paralytic disability from 14Nov2014 to 11May2021. Concomitant medications included levetiracetam, phenobarbital and lansoprazole. The patient experienced cardio-respiratory arrest (fatal) on 11May2021. The outcome of the event was fatal. Patient died on 11May2021. It was not reported if an autopsy was performed. Reporter comment: From the administration of the drug to the patient''s exit, there is no evidence of specific symptoms (patient in a vegetative state); Reported Cause(s) of Death: Cardio-respiratory arrest
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