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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1056106



Case Details

VAERS ID: 1056106 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-30
Onset:2021-02-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6134 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure immeasurable, Blood pressure measurement, Blood sodium, C-reactive protein, Chest X-ray, Diarrhoea, Electrocardiogram, Fibrin D dimer, Oxygen saturation, Oxygen saturation decreased, Renal function test, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPIN TEVA; CITALOPRAM ZENTIVA; FRONTIN; LAVESTRA; BETALOC [METOPROLOL SUCCINATE]; ATORIS
Current Illness: Dementia; Encephalopathy; Hypertension; Ischaemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210204; Test Name: Blood pressure; Result Unstructured Data: Test Result:96/70 mmHg; Comments: 96/70; Test Date: 20210204; Test Name: sodium; Result Unstructured Data: Test Result:hyponatraemia; Test Date: 20210204; Test Name: Chest X-ray; Result Unstructured Data: Test Result:bilateral infiltrates unchanged; Test Date: 20210204; Test Name: CRP; Result Unstructured Data: Test Result:high; Test Date: 20210204; Test Name: EKG; Result Unstructured Data: Test Result:tachycardia; Test Date: 20210204; Test Name: D-dimer; Result Unstructured Data: Test Result:high; Test Date: 20210204; Test Name: Oxygen saturation; Test Result: 80 %; Test Date: 20210204; Test Name: renal function; Result Unstructured Data: Test Result:decreased; Test Date: 20210126; Test Name: COVID-19 antigen test negative; Test Result: Negative ; Test Date: 20210111; Test Name: COVID-19 PCR test positive; Test Result: Positive
CDC Split Type: HUPFIZER INC2021183089

Write-up: blood pressure immeasurable; low oxygen saturation, around 80%; Diarrhoea; This is a spontaneous report from a contactable physician downloaded from the Agency HU-OGYI-050521. A 77-years-old female patient received the first dose of bnt162b2 (COMIRNATY, lot# EJ6134), intramuscular 0.3 mL single on 30Jan2021 at 09:26 for covid-19 immunisation. Medical history included ongoing encephalopathy, ongoing myocardial ischaemia, ongoing dementia, ongoing hypertension. Concomitant medications included amlodipine besilate (AMLODIPIN TEVA), citalopram hydrobromide (CITALOPRAM ZENTIVA), alprazolam (FRONTIN), losartan potassium (LAVESTRA), metoprolol succinate (BETALOC), atorvastatin calcium (ATORIS). The patient experienced diarrhoea on 01Feb2021, blood pressure immeasurable on 04Feb2021, low oxygen saturation, around 80% on 04Feb2021. On 04Feb2021, the patient was taken to the emergency due to 2-day-long diarrhoea, low oxygen saturation around 80%, and immeasurably low blood pressure. EKG and chest X-ray were performed. X-ray showed bilateral infiltrations which were unchanged since the previous scan. Decreased renal function, hyponatraemia, high CRP levels, and high D-dimer values showed in the patient''s laboratory tests. The patient underwent lab tests and procedures which included blood pressure measurement: 96/70 mmhg on 04Feb2021, chest x-ray: bilateral infiltrates unchanged on 04Feb2021, electrocardiogram: tachycardia on 04Feb2021, oxygen saturation: 80 % on 04Feb2021, sars-cov-2 test negative on 26Jan2021, sars-cov-2 test positive: positive on 11Jan2021. She received unknown infusion and dopamine perfursor was started. Sodium supplementation, oxygen supplementation, Solu-medrol (methylprednisolone, intravenously), ceftriaxon therapy, and low-dose LMWH prophylaxis was used in unknown dosages. On the day of admission, the patient was tachycard in the afternoon, her breathing was rapid, and metabolic acidosis was shown on the Astrup device. Bicarbonate was replaced. Her blood pressure was again immeasurably low, and the dose of vasopressor was increased. Later, her circulation collapsed, despite all of the efforts, the patient died on 04Feb2021 at 17:40. Autopsy was done, cause of death was left heart failure caused by ischaemic heart disease and generalised atherosclerosis. The lungs did not indicate possible COVID infection according to the pathological examination. Following diagnosis were reported: atherosclerosis generalized, ventricular hypertrophy hypertrophia, pulmonary oedema, hepatic steatosis, colelitiasis, arteriolosclerotic nephrosclerosis. The reporter physican did not consider the events to be related to vaccination. Sender Comment: 77-year-old patient died 5 days after vaccination with Comirnaty. Cause of death was left heart failure according to the autopsy. The causal relationship between the events and Comirnaty is considered unlikely. The case is serious due to the fatal outcome. No follow-up attempts are possible. No further information is expected; Sender''s Comments: Based on the clinical course description and the autopsy result, which revealed the cause of death was left heart failure caused by ischaemic heart disease and generalised atherosclerosis. The lungs did not indicate possible COVID infection according to the pathological examination, the Company, in concurrence with the sender, the events are unrelated to COVID-19 vaccine, BNT162B2, administration.; Reported Cause(s) of Death: diarrhea; Blood pressure immeasurable; Oxygen saturation decreased; Left heart failure


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