| VAERS ID: |
1003382 (history) |
| Form: |
Version 2.0 |
| Age: |
83.0 |
| Sex: |
Female |
| Location: |
Alabama |
| Vaccinated: | 2021-02-02 |
| Onset: | 2021-02-03 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-02-04 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL3302 / 1 |
LA / IM |
Administered by: Senior Living Purchased by: ?
Symptoms: Bradycardia,
Chest pain,
Condition aggravated,
Death,
Diarrhoea,
Full blood count,
Hypotension,
Metabolic function test,
Seizure,
Urine analysis,
Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-02-04
Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aricept, citalopram,carbamazepine, Atorvastatin, gabapentin, calcium citrate, metoprolol, amlodipine, vitamin D
Current Illness: COVID dx on 1/4/2021
Preexisting Conditions: Dementia, epilepsy, HTN, PVD, osteoporosis,
Allergies: PCN, Sulfa ATB
Diagnostic Lab Data: Did order CBC, carbamazepine level, UA and CMP. Results are pending
CDC Split Type:
Write-up: Began with vomiting and diarrhea. C/O chest pain. Bradycardia. Hypotension. 2 seizures in 45 minutes after not having one in years. We gave fluids. Gave Zofran. Comfort measures. Pt passed at midnight. Was completely fine one day before. Had minimal issues with COVID though did have a pneumonia that was treated w ATB early on and resolved. |
