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This is VAERS ID 1104978

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1104978
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-19
Onset:2021-02-01
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Death, Feeling cold, Malaise, Oral disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Benign prostatic hyperplasia; Cardiac valvulopathy; Chronic obstructive lung disease; Colon neoplasia; Hypertension arterial; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESPFIZER INC2021256515

Write-up: Malaise; initiation with cold feeling, deviation of oral commissure and later exitus; initiation with cold feeling, deviation of oral commissure and later exitus; initiation with cold feeling, deviation of oral commissure and later exitus; This is a spontaneous report downloaded from the Regulatory Authority-WEB (ES-AEMPS-776492). This is a spontaneous report from a physician. This is a report received from the Drug Agency, with the Regulatory authority report number ES-AEMPS-776492. A 97-year-old male patient received bnt162b2 (COMIRNATY, lot # EP9598), intramuscular at single dose on 19Feb2021 for COVID-19 immunization. Medical history included hypertension, benign prostatic hyperplasia, chronic obstructive pulmonary disease, type 2 diabetes mellitus, colon neoplasm, and cardiac valve disease. The patient''s concomitant medications were not reported. The patient experienced "initiation with cold feeling, deviation of oral commissure and later exitus" on 21Feb2021. The patient died in Feb2021. An autopsy was not performed but the initial or fundamental cause was colon neoplasia. End-stage disease. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Colon neoplasia. End-stage dsease

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