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This is VAERS ID 1339914

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1339914
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-05-08
Onset:2021-05-13
Submitted:0000-00-00
Entered:2021-05-22
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:2021-05-13
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: Smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021561306

Write-up: Death, died 4 days after vaccination. No complaints reported in advance. sudden death.; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB NL-LRB-00539807. A 71-year-old male patient received the first dose of BNT162b2 (COMIRNATY, Lot number unknown) via an unspecified route of administration on 08May2021 at single dose for COVID-19 immunisation. Relevant medical history included that the patient was a smoker. The patient had no previous COVID-19 infection. Concomitant medications were not reported. On 13May2021 the patient died due to sudden death, presumably cardiac based on the medical history. He had no complaints prior to his death. He had no complaints reported in advance. No autopsy was performed as wished by his family. Information about lot/batch number cannot be obtained. No further information expected.; Reported Cause(s) of Death: sudden death, presumably cardiac based on the story. no autopsy.

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