VAERS Results 01312021

Vaccine
Manufacturer
Event
Category
Age
VAERS
ID
Adverse Event Description
vaccine considered as suspect: none. It was unknown if there were additional vaccines
administered on the same date of the Pfizer suspect, but the reporter doubted it. There were no
prior vaccinations within 4 weeks. There were no adverse events following the prior
vaccinations. The clinical outcome of the event, died, was fatal. The clinical outcome of the
event, tested positive for COVID, was unknown. The patient died on 17Jan2021 due to an
unknown cause of death. An autopsy was not performed. The batch/lot numbers for the vaccine,
PFIZER-BIONTECH COVID-19 MRNA VACCINE, were not provided and will be requested during
follow up.; Reported Cause(s) of Death: died"
PFIZER\BIONTECH Death 65+ years 960552-1
At approximately 930am I arrived at Memory Care. I met with the director of the facility and she
directed me to where my team would be setting up. My team consisted of (technician), (nurse)
and I. As we were setting up, the director asked how she can help. I explained to her that we
would need a designated area for patients to be monitored after vaccination for 15 minutes and
maybe even longer . I also explained that we would need one of her staff monitoring while we
vaccinate. She agreed, and proceeded to designate her staff and the cafeteria area, facing the
vaccination station,the monitoring station. Throughout the day, nurse and I were both
vaccinating,while the staff of the facility would monitor the vaccinated patients. I would also
stop occasionally to mix the vaccine and check the temperature of the aero safe. At
approximately 12:50pm, the director rushed in and stated that a patient is not responding, and
that she had been vaccinated. At that point, I grabbed epipens and a thermometer and I also
instructed nurse to grab an Epipen and come with me. We followed the director to pt's room.
Once we got to the room, the patient was in bed and there were 4 staff members standing
bedside and one of them turned and stated the patient has passed. At that point I asked the staff
how long ago did the patient get the vaccine, they stated about 30 minutes ago. They also stated
that the patient was a hospice patient and that the patient had declined, and was rapidly
detiorating and had not eaten or drank anything all day . They also stated that the patient had
been monitored for 15 minutes post vaccination. I then left the room and grabbed the patients
COVID Vaccine intake consent form. I looked at the answered questionaire and all the responses
were circled NO. Patient had a temp of 96.5 at the time of vaccination.The vaccine
administration information for Immunizer Section was filled out by Nurse. I then proceeded to
ask the director once again if there were staff that was monitoring her for 15 minutes, the
director stated they had staff monitoring her. She also stated the Hospice nurse has to announce
her death, so they waited for the Hospice Nurse to come. I then called Corporate and explained