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This is VAERS ID 1064472

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1064472
VAERS Form:2
Age:84.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Dyspnoea, Oxygen saturation decreased, Pyrexia, Respiratory disorder, General physical health deterioration, Blood pressure measurement

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
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: PERINDOPRIL; XARELTO; AMLODIPIN [AMLODIPINE BESILATE]; ESCITALOPRAM; FOLIC ACID; D-VITAL CALCIUM; PANTOPRAZOLE; ATORVASTATIN; CITALOPRAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; Coronavirus infection; CVA; Degenerative aortic valve disease; Frailty (frailty 7: Completely dependent for personal care regardless of the cause (physical or cognitive)); Hypercholesterolemia; Liver metastases; Living in nursing home (living in Inpatient care center); Nephrectomy (before 2004); Osteoarthritis; Pacemaker insertion (cardiac)
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:decreased; Test Name: body temperature; Result Unstructured Data: Test Result:fever Centigrade; Test Date: 20210205; Test Name: body temperature; Result Unstructured Data: Test Result:38 Centigrade; Test Date: 20210205; Test Name: oxygen saturation low; Result Unstructured Data: Test Result:58
CDC 'Split Type': BEPFIZER INC2021192192

Write-up: Problem with the breathing; oxygen saturation decreased/saturation remained okay /saturation 58; very short of breath; Fever 38 centigrade; her condition deteriorated sharply during the day after vaccination; This is a spontaneous report from a contactable other healthcare professional downloaded from the Medicines Agency (MA) regulatory authority-WEB BE-FAMHP-DHH-N2021-77547, received from Regulatory Authority. An 84-year-old female patient received bnt162b2 (COMIRNATY, Batch/lot number: EM0477) at single dose, the 1st dose on an unknown date and the 2nd dose on 04Feb2021 for covid-19 immunisation. Medical history included coronavirus infection from Nov2020 to an unknown date, nephrectomy before 2004, poly osteoarthritis, arterial hypertension, hypercholesterolaemia, cardiac pacemaker insertion due to recurrent syncopes in 2004, ischemic stroke (CVA) in 2017 to an unknown date, degenerative valve disease, metastases to liver, living in Inpatient care center, frailty 7: Completely dependent for personal care regardless of the cause (physical or cognitive). Concomitant medication included perindopril (manufacturer unknown) 1 DF, 1x/day, rivaroxaban (XARELTO) 15 mg, 1x/day, amlodipine besilate (AMLODIPIN) 1 DF, 1x/day, escitalopram (manufacturer unknown) 1 DF, 1x/day, folic acid (manufacturer unknown), ascorbic acid, calcium carbonate, colecalciferol, ergocalciferol (D-VITAL CALCIUM), pantoprazole (PANTOPRAZOL) 1 DF, 1x/day, atorvastatin (manufacturer unknown) 1 DF, 1x/day, citalopram (manufacturer unknown). On an unknown date the 1st dose of bnt162b2, the patient experienced problem with the breathing, oxygen saturation decreased/saturation remained okay, very short of breath, fever, her condition deteriorated after vaccination and the symptoms were over after 48 hours. Her health status was certainly good at the time of the second vaccine administration. On 05Feb2021 the 2nd dose of bnt162b2, the patient experienced violent reaction to vaccine with the same events occurred with the 2st dose: problem with the breathing, saturation 58, very short of breath, fever 38 centigrade, her condition deteriorated sharply during the day after vaccination, but mor intense. She was treated: perdolan suppo against fever, oxygen therapy, temesta 1 mg, dafalgan, morphine 2 x 5 mg at 6:00 pm, morphine subcutaneous 20 mg at 7:15 pm, and 2 ampoules of buscopan. Morphine was administered because her condition deteriorated sharply during the day after vaccination to support breathing. The patient died on 05Feb2021, 26 hours after administration. The outcome of events was fatal. It was not reported if an autopsy was performed. Reporter''s comments: Treatment - Yes perdolan suppo against fever oxygen therapy temesta 1 mg dafalgan morphine 2 x 5 mg at 6:00 pm morphine subcutaneous 20 mg at 7:15 pm and 2 ampoules of buscopan Evolution of the ADR - Died. Situations - Other: Violent reaction to vaccine. ADR description - lady of 84 years, living in Inpatient care center, had Covid in November 2020 day. after second dose vaccination, saturation 58, very short of breath, 38 centigrade died 26 hours after administration also had the same symptoms after first dose vaccination but milder, was over after 48 hours. Frailty 7: Completely dependent for personal care regardless of the cause (physical or cognitive). Despite their care needs, they appear stable and there does not appear to be an increased risk of death (within 6 months). after the first vaccination, saturation remained okay, even though the lady had some fever. Her health status was certainly good at the time of the second vaccine administration. Morphine was administered because her condition deteriorated sharply during the day after vaccination to support breathing. Very low saturation. Died 26 hours after administration of the second dose. Batch/lot number: EM0477. Comirnaty, Reaction(s) / Event(s) Assessed: Fever. Relatedness of drug to reaction(s)/event(s). Source of assessment: FAMHP. Method of assessment: WHO. Result of Assessment: POSSIBLE. Comirnaty, Reaction(s) / Event(s) Assessed: Respiratory disorder, Oxygen saturation low, Shortness of breath, General physical health deterioration. Relatedness of drug to reaction(s)/event(s). Source of assessment: FAMHP. Method of assessment: WHO. Result of Assessment: unclassifiable. No follow-up attempts possible. No further information expected.; Reporter''s Comments: Treatm perdolan vs fever O2 ther temesta 1mg dafalgan morph2x5mg morph sbc20mg+2ampoul buscopan.Violent react to vacc.Lady84yo,inpatient care cent,Covid Nov2020 aft 2vacc,sat58,short breath,38C,same milder sympt aft 1vacc,over aft 48hr.Frailty7:Compl dep for personal care regard of cause.Appear stable,not an increas death risk(within6mo).Aft 1vacc,satur ok, though had some fever.Health status good at 2vacc.Morphine as her cond deter sharp day aft vacc to supp breath.Low sat.Died26hrs aft 2dose; Reported Cause(s) of Death: Problem with the breathing; saturation 58; very short of breath; Fever 38 centigrade; her condition deteriorated sharply during the day after vaccination

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