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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1061519



Case Details

VAERS ID: 1061519 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-31
Onset:2021-02-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9788 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, General physical health deterioration, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-11
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: KALIUMKLORID ORIFARM; CONTALGIN; BERODUAL; SCOPODERM [HYOSCINE]; LAXOBERAL; FURIX [CEFUROXIME]; PREGABALIN KRKA; PARACETAMOL ORIFARM; XARELTO
Current Illness: ALS (Terminal state. Able to speech, swallow and move both index fingers); Apnoea; Constipation; Pain; Phlegm (Increasing in the months close to vaccination)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DKPFIZER INC2021189957

Write-up: The physician can not exclude that the vaccination had an additive effect on already worsening state of health resulting in death/ exacerbation of disease; The physician can not exclude that the vaccination had an additive effect on already worsening state of health resulting in death.; lung edema; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB (DK-DKMA-WBS-0034363). A 71-year-old male patient received the second dose of BNT162B2 (COMIRNATY; Lot number: EK9788; Expiration date: 31May2021), via an unspecified route of administration, on 31Jan2021 at a single dose for COVID-19 immunisation. Medical history included amyotrophic lateral sclerosis (ALS) (terminal state; able to speech, swallow and move both index fingers) from 2019 and ongoing, ongoing phlegm (increasing in the months close to vaccination), ongoing apnoea, ongoing pain, and ongoing constipation. Concomitant medication included potassium chloride (KALIUMKLORID ORIFARM) taken as potassium supplementation from 18Nov2020, morphine sulfate (CONTALGIN) taken for pain from 07Jan2021, fenoterol hydrobromide, ipratropium bromide (BERODUAL) taken for drug use for unknown indication, hyoscine (SCOPODERM) taken as prophylaxis of nausea and vomiting from 29Jan2021, sodium picosulfate (LAXOBERAL) taken for constipation from 15Jan2020, cefuroxime (FURIX) taken as diuretic therapy from 24Aug2020, pregabalin (MANUFACTURED BY: KRKA) taken for pain, paracetamol (MANUFACTURED BY: ORIFARM) taken for pain from 22Apr2020, and rivaroxaban (XARELTO) taken for thrombosis prophylaxis from 17Nov2020. The patient previously received the first dose of BNT162B2 (COMIRNATY; Lot number: EM0477) on 06Jan2021 for COVID-19 immunisation. In Feb2021, the physician can not exclude that the vaccination had an additive effect on already worsening state of health resulting in death. The patient also experienced lung edema in Feb2021. The events were reported as fatal. The patient was treated with furosemide and fenoterol and ipratropium bromide with some effect, but the patient died relatively sudden on 11Feb2021. Therapeutic measures were taken as a result of the events as aforementioned. The patient died on 11Feb2021. The cause of death was reported as exacerbation of disease and lung edema, as well as worsening state of health resulting in death. An autopsy was not performed. The reporter stated that he could not exclude that the vaccination had an additive effect on already worsening state of health resulting in death. He did not suspect that the vaccination caused death. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: The physician can not exclude that the vaccination had an additive effect on already worsening state of health resulting in death; The physician can not exclude that the vaccination had an additive effect on already worsening state of health resultin


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