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This is VAERS ID 1108495

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1108495
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-24
Onset:2021-02-28
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6790 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-28
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: PARACETAMOL; ACETYLCYSTEINE; GANFORT; COMBIVENT; OXYCODON; CITALOPRAM; HALOPERIDOL; FLUTICASONE PROPIONATE; OXAZEPAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrioventricular block (2nd degree); Colon carcinoma (palliative policy); COPD; Living in nursing home (For 1 year)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021256578

Write-up: Death; This is a spontaneous report downloaded from the Agency regulatory authorities -WEB [Lareb (LRB) number NL-LRB-00459915] from a contactable physician. An 88-year-old male patient received the 2nd dose of bnt162b2 (COMIRNATY) (lot# EJ6790), via an unspecified route of administration, on 24Feb2021, at single dose, for COVID-19 immunisation. Medical history included chronic obstructive pulmonary disease, 2nd degree atrioventricular block, colon cancer (palliative policy), living in nursing home (for 1 year). Concomitant medications included paracetamol (unknown manufacturer), acetylcysteine (unknown manufacturer), bimatoprost, timolol maleate (GANFORT), ipratropium bromide, salbutamol sulfate (COMBIVENT), oxycodone hydrochloride (OXYCODON), citalopram (unknown manufacturer), haloperidol (unknown manufacturer), fluticasone propionate (unknown manufacturer), oxazepam (unknown manufacturer). The patient previously took the 1st dose of Comirnaty for COVID-19 immunisation and experienced no adverse event. The patient experienced death on 28Feb2021. It was not reported if an autopsy was performed.No clinical changes were seen between the vaccination and patient''s death. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: death

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1108495&WAYBACKHISTORY=ON

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