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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1086901



Case Details

VAERS ID: 1086901 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-01-31
Onset:2021-02-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphagia, Eating disorder, Oxygen saturation, Oxygen saturation decreased, Pneumonia, Toxicity to various agents
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CARVEDILOL; WARFARIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure (He was on Carvedilol from the heart doctor. That could have been for blood pressure); Dialysis (He had been doing dialysis for approximately 2.5 years); Lung disorder
Allergies:
Diagnostic Lab Data: Test Date: 20210201; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:His oxygen dropped too low to 76; Comments: His oxygen dropped too low to 76
CDC Split Type: USPFIZER INC2021247825

Write-up: His oxygen dropped too low to 76; Pneumonia; something with toxins; he couldn''t eat or swallow; he couldn''t eat or swallow; This is a spontaneous report from a contactable consumer. This consumer reported similar events for 2 patients. This is the 1st of 2 reports. This consumer (wife) reported for a 75-year-old male patient that received his first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), on 31Jan2021 (at the age of 75-years-old) for COVID-19 immunization. Medical history included dialysis for approximately 2.5 years, a lung problem, blood pressure. Concomitant medications included carvedilol and warfarin and other unspecified medications. The patient experienced pneumonia and died on 11Feb2021 03:00 AM. An autopsy was not performed. The cause of death was reported to be pneumonia. Clinical course was the follows the next day on 01Feb2021 at 9:30AM the patient was dressed and ready to go to dialysis. His oxygen dropped too low to 76. He wanted an ambulance called. He went into the hospital. The patient was confused, and he was not normally confused. In the hospital the physicians said he had pneumonia, but it wasn''t that bad. The doctors were baffled. He also was in the hospital for something with toxins. He had a lung problem for a long time. If he didn''t go to the bathroom the toxins were hitting the liver and then the toxins were going to the brain. When he was in the hospital he couldn''t eat or swallow. The first day he did eat a bit, but he had dialysis in the hospital, and it knocks him out. They were giving him antibiotics IV. He couldn''t swallow any of his pills. He was in there for 11 days and had not eaten. He couldn''t swallow any pills. He started going to sleep and they started giving him Morphine drip at the end. They couldn''t get any medicine in him because he couldn''t swallow. The patient died of pneumonia, the outcome of the other adverse events was unknown. Information on lot number/batch number has been requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021247875 Same report, different patient/event; Reported Cause(s) of Death: Pneumonia


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