National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1045502

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1045502
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1484 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Crepitations, Death, Diarrhoea, Dyspnoea, Fatigue, Pyrexia, Urine output decreased, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MIRTAZAPINE; MEMANTINE; RISPERDAL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dementia Alzheimer''s type
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': SEPFIZER INC2021158461

Write-up: Death for unknown reason; Slight fever; Decreased appetite; Loose stools; urine volume decreased (she also had a decreased fluide intake); more tired; slight dyspnoea; crackles; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) Regulatory Authority-WEB, Regulatory Authority number SE-MPA-2021-003234. Other case identifier number SE-MPA-1612867407348. An 80-year-old female received bnt162b2 (COMIRNATY, Expiration Date unknown) second dose in Feb2021 (Lot Number EJ6136) and first dose in Jan2021 (Lot Number EL1484), both via Intramuscular at 0.3ml single dose for COVID-19 immunisation. The patient''s medical history included dementia Alzheimer''s type and unknown if was ongoing. The concomitant medications included mirtazapine from 28Jan2019 to Feb2021; memantine from 06Aug2019 to Feb2021; risperidone (RISPERDAL) from 12Oct2019 to Feb2021. Patient developed decreased appetite, slight fever and loose stools the day after first dose in Jan2021. She got better but a few days before the second dose Comirnaty (21 days after 1st dose) patient got worsened with decreased appetite, stopped eating, urine volume decreased (she also had a decreased fluide intake) that continued after the second dose. The woman got more tired, had a slight dyspnoea and crackles the last days. Dies calmly four days after the second dose Comirnaty. During her last days patient also received single dose of morphine and Robinul. The MPA will request further information. The outcome of events was fatal. Unknown if autopsy had been done. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: decreased appetite; fever; loose stools; urine volume decreased; tiredness; dyspnoea; crackles; unknown cause of death

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1045502&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166