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This is VAERS ID 1064619

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1064619
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Lung disorder, Oxygen saturation decreased, Pneumonia aspiration, Respiratory distress, Respiratory tract congestion, SARS-CoV-2 test

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease (with total gabatization.); Bedridden; COVID-19
Diagnostic Lab Data: Test Date: 20210211; Test Name: COVID-19 test; Test Result: Negative ; Comments: at 7 a.m.
CDC 'Split Type': FRPFIZER INC2021197529

Write-up: respiratory congestion with desaturation (no quantified value).; respiratory congestion with desaturation (no quantified value).; inhalation lung disease; Distress respiratory; Pneumonia aspiration; This is a spontaneous report from physician downloaded from the Regulatory Authority-WEB FR-AFSSAPS-MA20210469. A 95-years-old female patient received first dose of bnt162b2 (COMIRNATY, lot EJ6788), intramuscular in left arm on 09Feb2021 at single dose for covid-19 immunisation. Medical history included ATCD COVID-19 yes in October 2020, without respiratory failure, severe Alzheimer''s disease with total gabatization, bedridden. The patient''s concomitant medications were not reported. The patient experienced distress respiratory on 10Feb2021, pneumonia aspiration on 10Feb2021, appearance of respiratory congestion with desaturation (no quantified value) on 10Feb2021 09:00 p.m. Diagnosis of inhalation lung disease. The patient underwent lab tests and procedures which included Covid test: negative on 11Feb2021 at 7 a.m. The patient died on 12Feb2021. It was not reported if an autopsy was performed. The seriousness criteria was death, hospitalization, life threatening. No follow-up attempts are possible, information on batch number already obtained.; Reported Cause(s) of Death: Distress respiratory; Pneumonia aspiration; respiratory congestion; desaturation; inhalation lung disease

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