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This is VAERS ID 1045506

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1045506
VAERS Form:2
Age:
Sex:Male
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 EJ6134 / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Blood creatinine, Blood sodium, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease; Diabetes; Hypertension; Parkinson''s disease; Renal failure; Rheumatic disorder
Allergies:
Diagnostic Lab Data: Test Name: Creatinine value; Result Unstructured Data: Test Result:worsened; Test Name: Sodium value; Result Unstructured Data: Test Result:worsened
CDC 'Split Type': SEPFIZER INC2021158468

Write-up: Diarrhoea; Vomiting; This is a spontaneous report from a contactable nurse downloaded from the Medicines Agency (MA) Regulatory Authority-WEB, Regulatory Authority number SE-MPA-2021-003489. Other case identifier number SE-MPA-1613029319186. An 80-year-old male patient started to receive bnt162b2 (COMIRNATY) Batch/lot number: EJ6134, intramuscular in Jan2021 at single dose for covid-19 immunisation. Medical history included Alzheimer''s disease from an unknown date and unknown if ongoing, Renal failure from an unknown date and unknown if ongoing , diabetes from an unknown date and unknown if ongoing, hypertension from an unknown date and unknown if ongoing, parkinson''s disease from an unknown date and unknown if ongoing, rheumatic disorder from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced diarrhoea and vomiting in Jan2021. Man with gradually deteriorating general condition due to severe kidney failure and dementia. Expected palliative care. Blood samples was taken before vaccination. The test results arrived after vaccination and showed worsened Creatinine value and a high Sodium value. The patient was tired and exhausted, did not receive food and drink. The man died four days after the vaccination was given. The patient underwent lab tests and procedures which included blood creatinine: worsened, blood sodium: worsened. The patient died in 2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Diarrhoea; Vomiting

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