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VAERS ID: 1000379

AGE: 99.99| SEX: F|State: FR

Description

Chest infection; positive COVID-19 virus test/suspected COVID-19; positive COVID-19 virus test/suspected COVID-19; This is a spontaneous report received from a contactable other healthcare professional by Pfizer from the products Regulatory Agency. Regulatory authority report number GB-MHRA-WEBCOVID-202101280002382610, Safety Report Unique Identifier GB-MHRA-ADR 24657514. A 100 years old female patient received bnt162b2 (Pfizer-BioNTech COVID-19 mRNA vaccine, Lot Number and Expiration Date unknown) via an unspecified route of administration on 06Jan2021 at single dose for COVID-19 immunisation. The patient's medical history heart failure. Patient is not enrolled in clinical trial. The concomitant medications was not reported. Patient had suspected COVID-19 from 15Jan2021. Onset of chest infection on 15Jan2021, revived the course of antibiotics. But the course not completed as became too poorly moved to the stage of end of life. Patient died on 27Jan2021. Lab test included positive COVID-19 virus test on 06Jan2021. The outcome of events was fatal. Unknown if autopsy was done. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: chest infection; positive COVID-19 virus test/suspected COVID-19; positive COVID-19 virus test/suspected COVID-19

Symptoms

COVID-19, Death, Lower respiratory tract infection, SARS-CoV-2 test positive

Vaccines

VAX DATE: 05 January 2021 | ONSET DATE: 05 January 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK

RECVDATE:
03 February 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
26 January 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
Test Date: 20210106; Test Name: COVID-19 virus test; Test Result: Positive
V_ADMINBY:
OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Heart failure
PRIOR_VAX:
SPLTTYPE:
GBPFIZER INC2021091335
FORM_VERS:
2
TODAYS_DATE:
01 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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