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From the 1/14/2022 release of VAERS data:

Found 3,619 cases where Vaccine is COVID19 and Symptom is COVID-19 and Patient Died

Government Disclaimer on use of this data



Case Details (Sorted by Age)

This is page 21 out of 362

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VAERS ID: 1099541 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-01-18
Onset:2021-02-05
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210205; Test Name: Covid-19 test; Result Unstructured Data: Test Result:Positive
CDC Split Type: BEPFIZER INC2021249392

Write-up: positive COVID-19 test; positive COVID-19 test; This is a spontaneous report from a contactable physician. A patient of unspecified age and gender received the first dose of bnt162b2 (COMIRNATY, lot number EM0477, expiration date not reported) , via an unspecified route of administration on 18Jan2021 at single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient was positive COVID-19 testo on 05Feb2021 with fatal outcome. The patient died on an unspecified date. It was not reported if an autopsy was performed. The cause of death was not reported. The patient only received the first dose as the patient was too sick for the second dose. Follow-up attemtps are not possible. No further information is expected.; Sender''s Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of COVID-19 virus test positive and drug ineffective due to temporal relationship. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: positive COVID-19 test; positive COVID-19 test


VAERS ID: 1099542 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-01-18
Onset:2021-02-11
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210211; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: BEPFIZER INC2021249393

Write-up: COVID-19; COVID-19; This is a spontaneous report from a contactable physician. A patient of unspecified age and gender received the 1st dose of bnt162b2 (COMIRNATY, lot# EM0477), via an unspecified route of administration, on 18Jan2021, at single dose, for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced COVID-19 on 11Feb2021 with fatal outcome on an unspecified date in 2021. It was not reported if an autopsy was performed. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on 11Feb2021. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information available, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported event COVID-19 leading to fatal outcome based on the known safety profile. However considering the relatively short duration since the vaccine first dose is given, it is unlikely the patient would have fully developed immunity. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: COVID-19; COVID-19


VAERS ID: 1099628 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-11
Onset:2021-02-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9788 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-19
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: CVA; Dementia; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210201; Test Name: COVID-19 PCR; Test Result: Negative ; Test Date: 20210216; Test Name: COVID-19 PCR; Test Result: Positive
CDC Split Type: FRPFIZER INC2021232809

Write-up: COVID-19 aggravated; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB. The Regulatory Authority report number is FR-AFSSAPS-BR20210398. A 93-year-old male patient received the first dose of BNT162B2 (COMIRNATY, batch number: EK9788, expiration date not reported), intramuscular on 11Feb2021 at a single dose for COVID-19 immunisation. Medical history included Type 2 diabetes mellitus, cerebrovascular accident (CVA), and dementia. The patient''s concomitant medications were not reported. The declaration was made by a domestic hospitalisation physician for a resident of a facility for dependent elderly people. Note the absence of a coordinating physician in this facility. On 01Feb2021, this patient left a Pneumology department which was the center of a large cluster on that date. PCR negative at the exit. He was admitted to facility for dependent elderly people. On 03Feb2021, his state of health began to deteriorate and this was initially attributed to frustration at leaving his home. On 11Feb2021, first injection of the COMIRNATY was administered with continued deterioration of the general condition. On 16Feb2021, the patient experienced bronchial congestion, stopping hydration and PCR COVID positive. On 17Feb2021, the patient experienced COVID-19 aggravated. On 18Feb2021, intervention by the domestic hospitalisation physician for respiratory deterioration (distress) with agitation and pain which appeared the day before which included introduction of hyoscine butylbromide (SCOBUREN) and midazolam. On 19Feb2021, death of the patient. In total, the patient probably infected with COVID before his first vaccine injection, which deteriorated in the days that followed. The domestic hospitalisation physician cannot rule out a severe form of COVID following vaccination. It was not reported if an autopsy was performed. No follow-up attempts are possible, no information is expected.; Reported Cause(s) of Death: COVID-19 aggravated


VAERS ID: 1099645 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-21
Onset:2021-01-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-27
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: CVA
Allergies:
Diagnostic Lab Data: Test Date: 20210125; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: FRPFIZER INC2021232850

Write-up: COVID-19 PCR test positive; COVID-19 aggravated/fever, rapidly worsening; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB regulatory authority FR-AFSSAPS-MP20210279. A 101-year-old female patient received first dose of bnt162b2 (COMIRNATY, solution for injection, lot: EJ6788), intramuscular on left arm on 21Jan2021 at single dose for covid-19 immunisation. Medical history included cerebrovascular accident (CVA) from 2013 to 2013 (not ongoing). The patient''s concomitant medications were not reported. On 22Jan2021, the patient experienced fever, rapidly worsening and COVID-19 aggravated. On 25Jan2021 with PCR test for COVID-19: positive, no variant testing. The patient died on 27Jan2021 due to COVID-19 and COVID-19 PCR test positive (reported as severe COVID leading to death). It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19 aggravated/fever, rapidly worsening; COVID-19 PCR test positive


VAERS ID: 1101613 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-15
Onset:2021-02-07
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-10
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19; Palliative care
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210207; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive; Test Date: 20210204; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative
CDC Split Type: ATPFIZER INC2021242199

Write-up: positive COVID-19 test with symptoms; positive COVID-19 test with symptoms with fatal outcome/died on 10Feb2021; This is a spontaneous report from a contactable physician downloaded from the Regulatory Agency-WEB AT-BASGAGES-2021-04888. A 90-year-old female patient received first dose of BNT162B2 (COMIRNATY, lot number: EL1491), via an unspecified route of administration on 15Jan2021 at single dose for COVID-19 immunisation. Medical history included ongoing palliative care palliative and COVID-19 from 07Feb2020 and ongoing. The patient''s concomitant medications were not reported. On 07Feb2021, the patient experienced positive COVID-19 test with symptoms with fatal outcome. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on 07Feb2021 and COVID-19 virus test negative on 04Feb2021. The patient died on 10Feb2021. It was not reported if an autopsy was performed. No follow-up attempts are possible, batch number already obtained. Amendment: This follow-up report is being submitted to allow appropriate reporting to health authorities.; Reported Cause(s) of Death: COVID-19 respiratory infection


VAERS ID: 1104932 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-09
Onset:2021-01-22
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-02
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Cardiac failure chronic
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 Test porsitiv; Result Unstructured Data: Test Result:Positive; Comments: tests in the old people''s home was negative. After the hospitalisation was the COVID-.PCR-Test positive
CDC Split Type: DEPFIZER INC2021266944

Write-up: shortness of breath; PCR test was then made and turned out positive; Death; This is a spontaneous report downloaded from the Regulatory Authority-WEB regulatory authority number DE-PEI-CADR2021017328. A non-contactable consumer reported that a 95-year-old female patient received BNT162b2 (COMIRNATY, solution for injection, batch/lot: unknown), via an intramuscular route of administration on 09Jan2021 at single dose for COVID-19 immunization. Medical history included ongoing cardiac failure chronic. Concomitant medications was not reported. Heart failure / the person complained 10 days after vaccination about shortness of breath and thus directed to the city hospital. The person was from the beginning of December in quarantine since there was a positive case in the home. All PCR tests were negative. In the hospital a PCR test was then made and turned out positive. On 02Feb2021 the person died. The cause of death was unknown. Outcome of death was fatal and outcome of both events was not recovered. Causality from regulatory authority: Inconsistent causal association to immunization No follow-up attempts are needed, follow-up automatically provided by regulatory authority.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1104992 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-29
Onset:2021-02-08
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Hypoxia, Polymerase chain reaction, SARS-CoV-2 test, Vaccination failure
SMQs:, Asthma/bronchospasm (broad), Lack of efficacy/effect (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-14
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic bronchitis; Dementia; Embolism pulmonary; Hypertension arterial
Allergies:
Diagnostic Lab Data: Test Date: 20210202; Test Name: PCR; Test Result: Negative ; Test Date: 20210208; Test Name: SARS-CoV-2 test; Test Result: Positive
CDC Split Type: FRPFIZER INC2021250309

Write-up: Hypoxia; Vaccination Failure; COVID-19; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB. The regulatory authority report number is FR-AFSSAPS-CF20210232. A 91-year-old female patient received BNT162B2 (COMIRNATY), intramuscular with the first dose on 08Jan2021 (Lot number unknown) and the second dose in the left arm on 29Jan2021 (Lot number EJ6788) and second dose (Lot number EJ6788) for covid-19 immunization. Medical history included hypertension arterial, dementia, pulmonary embolism, chronic bronchitis, each from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced covid-19 and vaccination failure on 08Feb2021; the patient also experienced hypoxia on 14Feb2021. The events were serious as they lead to death. The patient underwent lab tests and procedures which included polymerase chain reaction (PCR), which was negative on 02Feb2021; SARS-CoV-2 test which was positive on 08Feb2021. The clinical course was as follows: the first injection was given on 08Jan2021. The patient tested positive for COVID-19 on 08Feb2021 (about 10 days after the second injection), but tested negative for PCR on 02Feb2021. As of 08Feb2021, this patient presented fatigue without clinical signs (absence of oedema, urticaria, respiratory and cardiocirculatory failure). On 14Feb2021, the patient''s condition deteriorated. A rapidly settling hypoxia was observed requiring the intervention of the doctor on duty in emergency. Death occurred within 15-20 minutes after the hypoxia was detected. Death of the patient occurred before she could be hospitalised. No search for a viral variant was performed. Hypoxia stop date was reported as 14Feb2021, with fatal outcome. The patient died on 14Feb2021. An autopsy was not performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1110758 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-29
Onset:2021-01-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: SARS-CoV-2 test; Result Unstructured Data: Test Result:Positive
CDC Split Type: DEPFIZER INC2021125922

Write-up: positive COVID-19 test with symptoms; positive COVID-19 test with symptoms; death; This is a spontaneous report from a contactable other hcp based on information received by Pfizer from Biontech (manufacturer control number unknwn), license partner for COMIRNATY. A 85-year-old female patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 29Dec2020 at single dose for covid-19 vaccination. The patient medical history and the patient''s concomitant medications were not reported. The patient had a positive covid-test on an unspecified date, typical symptoms and died on 03Jan2021. It was not reported if an autopsy was performed. The patient was vaccinated prior to her death. According to the staff of the hospital, the patient received a positive COVID-Test on the day of her death, after she had developed typical symptoms 2 days prior and therefore was switched to the "Covid-Station" of the nursing home. Over the further cause the vaccination symptoms increased and the patient died. Information about batch number was not available and is going to be requested.; Sender''s Comments: Death of unknown cause is assessed related as a cautionary measure and for reporting purposes. Based on the information available, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported positive COVID-Test based on the known safety profile. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1111113 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Breath sounds abnormal, COVID-19, Drug ineffective, Hypopnoea, Illness, Lethargy, Pyrexia, Respiratory rate increased, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-01-19
   Days after onset: 28
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPINE; BISOPROLOL
Current Illness: Gastrointestinal carcinoma (In remission since 2018)
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Neoplasm (Recently treated (radiotherapy or chemotherapy)); Surgery; Comments: Patient has not had symptoms associated with COVID-19. Unsure if patient is enrolled in clinical trial.
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Test Date: 20201230; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: GBPFIZER INC2021121224

Write-up: COVID-19 virus test positive; COVID-19 virus test positive; Breathing became progressively worse: fast, shallowand noisy.; Breathing became progressively worse: fast, shallowand noisy.; Breathing became progressively worse: fast, shallowand noisy.; Patient became very sick; Fever; lethargic; This is a spontaneous report from a contactable consumer (patient''s wife) received from the MHRA. The Agency Regulatory Authority report number is GB-MHRA-WEBCOVID-202102030931565490. Safety Report Unique Identifier GB-MHRA-ADR 24689483. A 53-year-old male patient received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech, lot# EJ1688), via an unspecified route of administration, on 22Dec2020, at single dose, for COVID-19 immunisation. Medical history included neoplasm (recently treated (radiotherapy or chemotherapy)), gastrointestinal carcinoma from 2017 and ongoing (in remission since 2018), surgery (not ongoing), atrial fibrillation from 2017 (unknown if ongoing). Patient has not had symptoms associated with COVID-19. Unsure if patient was enrolled in clinical trial. Concomitant medications included amlodipine (unknown manufacturer) and bisoprolol (unknown manufacturer). The patient experienced COVID-19 virus test positive (death, hospitalization, medically significant, life threatening) on 30Dec2020, patient became very sick (hospitalization, life threatening) on 22Dec2020 evening with outcome of unknown, fever (hospitalization, life threatening) on 22Dec2020 with outcome of unknown, lethargic (hospitalization, life threatening) on 22Dec2020 with outcome of unknown, breathing became progressively worse: fast, shallow and noisy (hospitalization, life threatening) on 24Dec2020 with outcome of unknown. The patient underwent lab tests and procedures which included COVID-19 virus test: negative on unknown date, positive on 30Dec2020. The patient died on 19Jan2021 due to COVID-19 virus test positive. It was not reported if an autopsy was performed. Clinical course was as follow: from 22Dec2020 evening the patient became very sick. He had fever and was lethargic. Patient''s wife assumed it was the expected side effects. On 24Dec2020 the breathing became progressively worse: fast, shallow, and noisy. 4 or 5 days after vaccination, in Dec2020, in the middle of the night 999 was called, he was taken to hospital and was hospitalized due to the events. On 19Jan2021, about 3 weeks after, the patient died due to COVID-19 virus test positive (underwent on 30Dec2020). No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19 virus test positive; COVID-19 virus test positive


VAERS ID: 1112855 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-14
Onset:2021-01-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2163 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Haematemesis, SARS-CoV-2 test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210117; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: COVID pos in hospital
CDC Split Type: ATPFIZER INC2021250307

Write-up: SARS COVID 19; died within a week; Haematemesis; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB [regulatory authority number AT-BASGAGES-2021-09458]. A 76-year-old male patient received his first dose of BNT162b2 (COMIRNATY, lot number EP2163), intramuscular on 14Jan2021, at single dose for COVID-19 immunisation. The patient medical and concomitant medications were not reported. The patient experienced haematemesis and SARS COVID 19 on 17Jan2021. On 17Jan2021 the patient was hospitalized. On the same day, in hospital, the patient was found positive COVID-19 PCR test. The patient was vaccinated on Thursday and was positive on Sunday, so was probably vaccinated in the incubation period. Previously, he was never tested positive and tests were carried out very frequently in the affected nursing home. Patient was hospitalized on 17Jan2021 and died within a week due to SARS COVID 19 (on unspecified date in Jan2021). The outcome of event haematemesis was unknown. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: SARS COVID 19; died within a week


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