VAERS ID: 1381218

AGE: | SEX: U|STATE: CA (United States)

Description

All died within the 5 weeks after first shot; This is a spontaneous report from a contactable consumer. This consumer reported similar events for six patients. This is the fourth of six reports. An elderly patient of an unknown gender and age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, on an unspecified date of 2021, as single dose for COVID-19 immunization. The patient' s medical history and concomitant medications were not reported. On unknown date, in 2021, the patient died within the 5 weeks after the first vaccination. It was not reported if an autopsy was performed. The patient was in a residential home with 5 other elderly residents. He/she died in sleep. The information on the lot number has been requested.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021617030 same reporter/SD/AE, different patients; Reported Cause(s) of Death: All died within the 5 weeks after first shot

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Symptoms

Death

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH Unknown Unknown

RECVDATE:06-08-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:USPFIZER INC2021618004
FORM_VERS:2
TODAYS_DATE:06-03-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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