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This is VAERS ID 1061506

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1061506
VAERS Form:2
Age:81.0
Sex:Male
Location:Foreign
Vaccinated:2021-02-12
Onset:2021-02-13
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEL8723 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Acute abdomen, Intestinal ischaemia, Respiratory failure, Septic shock

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-13
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; COPD; Dementia; Hypertension arterial
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021191550

Write-up: Acute abdomen; Septic shock; Mesenteric ischaemia; Respiratory failure; This is a spontaneous report from a non-contactable physician via Regulatory Authority. An 81-year-old male patient received the first dose of bnt162b2 (COMIRNATY) (Lot no. BEL8723), intramuscular at single dose on 12Feb2021 for covid-19 immunisation. Medical history included atrial fibrillation, dementia, hypertension arterial, chronic obstructive pulmonary disease (COPD). Concomitant medications were not reported. On 13Feb2021, the patient developed acute abdomen, septic shock, mesenteric ischaemia, respiratory failure. The patient was hospitalized and condition was life threatening. The patient died on 13Feb2021. It was not reported if an autopsy was performed. Death cause was reported as mesenteric ischaemia. Comirnaty/to all events/C. Inconsistent causal association. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Mesenteric ischaemia

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