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This is VAERS ID 1048626

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048626
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Cardio-respiratory arrest, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gastric ulcer; Melanoma; Penicillin allergy; Pneumonia; Stroke
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative
CDC 'Split Type': PTPFIZER INC2021163772

Write-up: Cardio-respiratory arrest; conclusion that she caught Covid and the vaccine did not protect her/ extreme tiredness/ a slight cough/ a fever; This is as spontaneous report received from a contactable consumer downloaded from the Medicine Agency (MA) Regulatory Authority-WEB. The regulatory authority report number is PT-INFARMED-T202102-951. A contactable consumer reported that a 92-years-old female patient received 1st dose of bnt162b2 (COMIRNATY), intramuscular on 19Jan2021 at 0.3 mL single for covid-19 immunisation. There was reference to clinical history in the past of melanoma, stroke, gastric ulcer, pneumonia and unknown if ongoing. There was a history of allergy to penicillin. Concomitant medication included esomeprazole, furosemide, clopidogrel. The adverse reaction, appeared about 6 days after the administration of the first dose of the suspected drug (25Jan2021), and was initially characterized by extreme tiredness that led her to eat in the bedroom and a slight cough. After 9 days of inoculation, a fever developed. The patient died on the 10th day (29Jan2021). The conclusion was that the patient caught COVID and the vaccine did not protect her associated with the use of bnt162b2 against COVID-19 (with modified nucleoside), 30 mcg/0.3 ml, concentrate for dispersion for injection, in 1st dose, for active immunization to prevent COVID-19 caused by the SARS-CoV virus-2, with the dosage of 2 intramuscular doses (0.3 ml each) with an interval of at least 21 days between each dose. The patient was not previously infected with the SARS-CoV-2 virus, according to the notifier, the patient was institutionalized and everyone tested Covid, they were confined to their rooms, the test result was negative. The patient died of cardiorespiratory arrest. No autopsy was performed. There was no concrete diagnosis of Covid infection, the notifier said in funeral homes say they would be treated as a suspect for Covid and, according to information from the institution, they were also hit hard by this plague. Evolution of adverse reaction was death. There was no reduction in dosage. The suspected drug was suspended once the vaccination schedule was incomplete, and the second dose was not administered. There was no suspicion of interaction between drugs. There is no information on the specific treatment of the reaction. The events outcome was fatal. No follow-up attempts are possible, information about batch number cannot be obtained.; Reported Cause(s) of Death: conclusion that she caught Covid and the vaccine did not protect her/ extreme tiredness/ a slight cough/ a fever; Cardio-respiratory arrest

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