Adverse Event Reporting

VAERS ID 914961
Gender Female
Age 88
StateCode KY
Pharmaceutical Company PFIZER\BIONTECH
Lot Number EL0142
Number of vaccinations 1
Vaccinated 2020-12-30
Onset 2020-12-30
Condition Died
  • Death

Current Illness

per nursing home staff over 14 days post covid

Preexisting Conditions

Other Medications

Previous Vaccinations


none listed

Laboratory Data


pt passed away with an hour to hour and 1/2 of receiving vaccine.
per nursing home staff they did not expect pt to make it many more days.
pt was unresponsive in room when shot was given.
per nursing home staff pt was 14 + days post covid