Adverse Event Reporting

VAERS ID 921768
Gender Female
Age 58
StateCode WA
Pharmaceutical Company PFIZER\BIONTECH
Lot Number EL0140
Number of vaccinations 1
Vaccinated 2021-01-04
Onset 2021-01-04
Condition Died
  • Fatigue
  • Feeling hot
  • Dizziness
  • Dyspnoea
  • Nausea
  • Hot flush
  • Syncope
  • Lethargy
  • Respiratory rate decreased
  • Death
  • Cardiac arrest

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations


None Known

Laboratory Data

Autopsy scheduled for 01/07/2021


Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper.
About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down.
Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing.
She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived.