National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1067742

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1067742
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Back pain, Diarrhoea, Faeces discoloured, Pain, Pain in extremity, Decreased appetite, Hypophagia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COPD; Diarrhea; Gastritis; High cholesterol; Hypertension; Type 2 diabetes mellitus; Comments: Type 2 diabetes mellitus Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021210141

Write-up: diarrhoea; reduced eating; diarrhoea dark brown and green watery stool; Diarrhoea; reduced appetite; generalised aches; leg pain; lower back pain; This is a spontaneous report from a contactable physician. This is a report received from the MHRA. Regulatory authority report number GB-MHRA-WEBCOVID-202102181535108410, Safety Report Unique Identifier GB-MHRA-ADR 24827783. A 73-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) on 29Jan2021 at a single dose for COVID-19 immunisation. Medical history included type 2 diabetes mellitus, diarrhea, chronic obstructive pulmonary disease (COPD), gastritis, hypertension, high cholesterol. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient is not enrolled in clinical trial. Concomitant medications included tiotropium bromide (BRALTUS) from 01Jul2017 for COPD, lansoprazole from 04May2010 for gastritis, lisinopril from 20Dec2020 for hypertension, fluticasone furoate, vilanterol trifenatate (RELVAR ELLIPTA) from 22May2017 for COPD, rosuvastatin from 25Nov2020 for blood cholesterol increased. Patient experienced diarrhea on an unspecified date with outcome fatal, diarrhoea on 30Jan2021 with outcome fatal. 1st Feb - NHS 111- started with diarrhoea on 30Jan2021, reduced appetite and generalised aches, leg pain, lower back pain. 4th Feb - GTD - diarrhoea since the day after covid injection. reduced eating, drinking ok. Slightly picked up on Tuesday, now diarrhoea dark brown and green watery stool. Notification from REDACTED Hospital - patient admitted on 05Feb2021 and died on 09Feb2021 due to diarrhoea. It was not reported if an autopsy was performed. The outcome of other events was unknown. Patient has not tested positive for COVID-19 since having the vaccine. No follow-up attempts possible; information regarding batch/lot cannot be obtained; No further information expected.; Reported Cause(s) of Death: Diarrhoea; Diarrhoea

New Search

Link To This Search Result:

Government Disclaimer on use of this data

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166