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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EM0477 / UNK||- / -|
Administered by: Other Purchased by: ??
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: MACROGOL; PARACETAMOL; CYANOCOBALAMINE; CALCIUMCARBONAAT; BUMETANIDE; CLOPIDOGREL; COLECALCIFEROL; LOSARTAN; PANTOPRAZOLE
Current Illness: Heart failure
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021191256
Write-up: Death; This is a spontaneous report received from a contactable other health professional downloaded from the Regulatory Agency NL-LRB-00444824. A 93-year-old male patient received BNT162B2 (COMIRNATY, lot number: EM0477), via an unspecified route of administration on 28Jan2021 at single dose for COVID-19 immunization. Medical history included ongoing severe heart failure. Concomitant medication included macrogol at one dose form, paracetamol (formulation: tablet, strength: 1000 mg) at 1000 mg, cyanocobalamine (formulation: tablet) at 1000 ug, calciumcarbonaat (formulation: chewable tablet) at one dose form (680/80 mg), bumetanide (formulation: tablet) at 0.5 mg , clopidogrel (formulation: tablet) at 75 mg, colecalciferol (formulation: capsule) at 5600 iU, losartan (formulation: film-coated tablet) at 25 mg and pantoprazole (formulation: gastro-resistant tablet) at 40 mg. The patient death occurred on 30Jan2021, unknown cause of death. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: unknown cause of death
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