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This is VAERS ID 1056348

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1056348
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-09
Onset:2021-02-10
Submitted:0000-00-00
Entered:2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6795 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Conjunctival oedema, Lip swelling, Malaise, Pyrexia, Swelling face, Swollen tongue, Peripheral swelling, Cardiopulmonary failure, Mouth swelling

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-12
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: HALDOL; OMEPRAZOLE; MACROGOL; AUGMENTIN [AMOXICILLIN;CLAVULANIC ACID]; MORFINE; PRIMPERAN; SALBUTAMOL; COLECALCIFEROL
Current Illness: Aspiration pneumonia; Delirium
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210209; Test Name: fever; Result Unstructured Data: Test Result:no fever
CDC 'Split Type': NLPFIZER INC2021191257

Write-up: swelling mouth; left arm; breathing and circulation were insufficient; Swelling face; Conjunctival swelling; increasing illness; complaints of the tongue, seemed a bit thick; complaints of the lip, seemed a bit thick; This is a spontaneous report from a contactable physician via the pharmacovigilance center (LAREB) downloaded from the Medicines Agency (MA) Regulatory Authority-WEB NL-LRB-00443834 A 74-years-old male patient received the second dose of bnt162b2 (COMIRNATY, lot EJ6795), via an unspecified route of administration on 09Feb2021 at single dose for covid-19 immunisation. Medical history included delirium and pneumonia aspiration both from 08Feb2021 and ongoing (were suspected). The patient had no previous COVID-19 infection. Concomitant medication included haloperidol (HALDOL), omeprazole (unknown manufacturer), macrogol (unknown manufacturer), amoxicillin, clavulanic acid (AUGMENTIN), morfine (unknown manufacturer), metoclopramide hydrochloride (PRIMPERAN), salbutamol (unknown manufacturer), colecalciferol (unknown manufacturer). The patient experienced swelling mouth, left arm, breathing and circulation were insufficient, swelling face, conjunctival swelling, increasing illness on 12Feb2021; complaints of the lip, seemed a bit thick and complaints of the tongue, seemed a bit thick on 10Feb2021. Cause of death was reported as unknown, anyway fatal outcome was reported for all the events. The patient died on 12Feb2021. It was not reported if an autopsy was performed. The reporter described that the day before vaccination an aspiration pneumonia with a delirium were suspected, for which amoxicillin/clavulanic acid and haloperidol were started. One day later, on the day of vaccination, the patient had no pyrexia. One day after vaccination, the patients tongue and lip seemed sligthly swollen. The next evening, the same events were reported again. A candida infection was suspected due to the use of amoxicillin/clavulanic acid and examination by the physician would follow the next day. The next morning, 3 days after vaccination, the patient did not react and his whole face, mouth, tongue, conjunctivae and left arm where swollen and there was cardiopulmonary insufficiency. Palliative policy followed after which the patient deceased several hours later. Differential diagnostic was thought of the aspiration pneumonia, sepsis, lupus erythemathosus and vena cava superior syndrome. The influence of the coronavaccination is unknown.; Reported Cause(s) of Death: swelling mouth; swelling left arm; breathing and circulation were insufficient; complaints of the lip, seemed a bit thick; Swelling face; Conjunctival swelling; increasing illness; complaints of the tongue, seemed a bit thick; Unknown cause of death

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