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This is VAERS ID 1107094

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1107094
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-01
Onset:2021-02-01
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6134 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Blood alkaline phosphatase, Blood bilirubin, Jaundice

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Aortic valve stenosis; Dementia; Hypertension; Memory impairment; Obstipation; Stroke
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: ALAT; Result Unstructured Data: Test Result:3,9; Test Date: 2021; Test Name: ASAT; Result Unstructured Data: Test Result:5,31; Test Date: 2021; Test Name: ALP; Result Unstructured Data: Test Result:15; Test Date: 2021; Test Name: bilirubin; Result Unstructured Data: Test Result:97
CDC 'Split Type': SEPFIZER INC2021250724

Write-up: Icterus; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number SE-MPA-2021-006569. Other case identifier number SE-MPA-1613996929890. A 95-year-old male patient received second dose of bnt162b2 (COMIRNATY; lot/batch EJ6134), via an unspecified route of administration in Jan2021 at single dose for COVID-19 immunization. Medical history included hypertension, obstipation, dementia, stroke, memory impairment, and aortic valve stenosis. The patient received first dose of bnt162b2 on an unspecified date for COVID-19 immunization. The patient''s concomitant medications were not reported. In Feb2021, the patient experienced icterus. The reporter stated that four days after the second dose, they started to see signs of icterus. No abdominal pain, initially well-being but quickly deteriorated due to reduced food and fluid intake. The patient was planned for investigation with DT abdomen but could not carry out the examination and patient described as worsened quickly and died 2.5 weeks later. Autopsy will not be performed according to the reporter. Furthermore, the reporter stated that he cannot assess the cause of acute jaundice, even though it was probably not linked to the vaccination. The patient underwent lab tests and procedures in 2021 which included alanine aminotransferase (ALAT): 3.9, aspartate aminotransferase (ASAT): 5.31 and alkaline phosphatase (ALP) was 15 and bilirubin: 97. The patient died on an unspecified date due to icterus. An autopsy was not performed. No follow-up attempts possible. No further information expected.; Sender''s Comments: As an individual case report there is not enough evidence to establish a causal relationship with the suspect vaccine. Currently there is no clear biological plausibility between the vaccine use and the even icterus onset.; Reported Cause(s) of Death: Icterus

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