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This is VAERS ID 1048218

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048218
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-04
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6136 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Blood pressure diastolic, Blood pressure systolic, Body temperature, Fatigue, Gait disturbance, Heart rate, Hypotonia, Marasmus, Oxygen saturation, Hypophagia, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-07
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: XARELTO; MOLAXOLE
Current Illness: Alzheimer''s disease; Aortic valve stenosis; Atrial flutter; Bee sting hypersensitivity (Bee sting allergy); Chronic atrial fibrillation (chronic atrial fibrillation arrhythmia); Conduct behaviour disorder (other organ. Personality and behavioral disorders since 04Jul2017); Delusion (delusional disorder since 04Jul2017); Dysphagia; Hearing loss; Osteoporosis; Personality disorder (other organ. Personality and behavioral disorders since 04Jul2017)
Preexisting Conditions: Medical History/Concurrent Conditions: Fall (Fall on 31Oct2019); Joint arthroplasty; Subarachnoid haemorrhage (Smallest subarachnoid hemorrhage on the left frontal)
Allergies:
Diagnostic Lab Data: Test Date: 20210206; Test Name: Diastolic blood pressure; Result Unstructured Data: Test Result:60 mmHg; Test Date: 20210206; Test Name: Systolic blood pressure; Result Unstructured Data: Test Result:110 mmHg; Test Date: 20210206; Test Name: Body temperature; Result Unstructured Data: Test Result:36.9 Centigrade; Test Date: 20210206; Test Name: Heart rate; Result Unstructured Data: Test Result:99; Comments: CPM; Test Date: 20210206; Test Name: Oxygen saturation; Test Result: 93 %; Test Date: 20210206; Test Name: COVID-19 antigen test; Test Result: Negative
CDC 'Split Type': ATPFIZER INC2021159812

Write-up: patient died on 07Feb2021 from Marasmus; powerless; Fatigue; limp; Floppy; reduced oral intake; This is a spontaneous report from other healthcare professional downloaded from the Medicines Agency (MA) Regulatory Authority-WEB AT-BASGAGES-2021-01701 and received via Regulatory Authority. A 91-year-old female patient received the second dose of BNT162B2 (COMIRNATY, batch/lot number: EJ6136), Intramuscular at single dose on 04Feb2021 for COVID-19 immunisation. The patient''s medical history and concurrent conditions included ongoing other organ. Personality and behavioral disorders since 04Jul2017, ongoing delusional disorder since 04Jul2017, ongoing Alzheimer''s disease since 04Jul2017, ongoing Hearing loss since 04Jul2017, Atrial flutter and atrial fibrillation since 04Jul2017, Smallest subarachnoid hemorrhage on the left frontal since 20Feb2019 and unknown if ongoing, ongoing chronic atrial fibrillation arrhythmia since 07May2019, ongoing Aortic valve stenosis since 07May2019, ongoing Osteoporosis since 07May2019, Fall on 31Oct2019, ongoing Dysphagia since 06May2020 and ongoing Bee sting allergy. Above all, paradoxical moderate to high-grade aortic valve stenosis with a BSA of 1 cm since 05May2019; Mainly right occipital hemorrhage since 20Feb2019; VLC frontalis right and VLC occipitalis since 20Feb2019; VLC reg frontal since 31Oct2019; VLC min intranasal dext, fract dent 1., 1.2, 1.3 since 12Aug2020; VLC reg periorb dext since 31Oct2019; Presence of orthopedic. Joint implants since 04Jul2017. Concomitant medications included macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (MOLAXOLE) for obstipation from 22Aug2019, rivaroxaban (XARELTO) from 04Mar2019 to 03Feb2021 and then from 05Feb2021 for Atrial fibrillation. The patient previously received the first dose of BNT162B2 (COMIRNATY) for COVID-19 immunisation on 14Jan2021. At the time of vaccination there were no signs of infection. A rapid antigen test was carried out on 06Feb2021, but it was negative. On 06Feb2021 12:00, the patient experienced tiredness, floppy, weakness. On 06Feb2021 at 12 o''clock the patient felt tired, limp, powerless. Due to reduced oral intake, 500 ml NaCl 0.9% infusion was administered sc. Vital signs included RR (Systolic blood pressure /Diastolic blood pressure) 110/60 mmHg, pulse 99 CPM, temperature 36.9 ? C, Oxygen saturation 93% on 06Feb2021. On 07Feb2021 08:45 the patient experienced Death NOS death. The patient''s outcome was not recovered/not resolved. The patient died on 07Feb2021 from Marasmus. No autopsy was arranged according to the medical officer. Cause of death according to the death certificate was senile marasmus. Other essential Disease conditions that contributed to death (according to death certificate): SDAT (Senile dementia of Alzheimer''s type), VHFL, aortic valve stenosis. Health Authority Comment: Confounding factors: elderly age, underlying disease (atrial fibrillation) Temporal relationship: 3 days The causal relationship between the product/substance COMIRNATY / TOZINAMERAN and tiredness, weakness and floppy is assessed as Possible. The causal relationship between the product/substance COMIRNATY / TOZINAMERAN and Death NOS is assessed as possible. The information provided in this individual case does not warrant a change in the product information or other measures. The case will be closed at this time. The topic will be monitored closely. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: senile marasmus

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