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

This is VAERS ID 1111248



Case Details

VAERS ID: 1111248 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-01
Onset:2020-12-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ 6795 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Cardiac failure, Death, Dyspnoea, Productive cough, Wheezing
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CITALOPRAM SANDOZ; MORFIN ABCUR; TROMBYL; MONOPROST; MIDAZOLAM ACCORD; CANODERM; FURIX [FUROSEMIDE]; BEHEPAN [CYANOCOBALAMIN]; GABAPENTIN ACCORD; FOLACIN [FOLIC ACID]; METOPROLOL ORION; AZOPT; FENTANYL MYLAN; OXYNORM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dementia; Hypertension; Mixed anxiety and depressive disorder; Senile cataract; Stroke
Allergies:
Diagnostic Lab Data:
CDC Split Type: SEPFIZER INC2021120419

Write-up: Dead 45 minutes after the vaccination; Wheeze; Phlegm; Heart insufficiency; Breathing difficult; This is a spontaneous report from a contactable pharmacist downloaded from the Agency Regulatory Authority-WEB , SE-MPA-1611739167214. Safety Report Unique Identifier SE-MPA-2021-001770. A 92-year-old female patient received bnt162b2 (COMIRNATY) (Lot # EJ 6795), intramuscular at 0.3 mL, single on an unspecified date in Dec2020 for Covid-19 immunisation. Medical history included hypertension, cerebrovascular accident, dementia, mixed anxiety and depressive disorder, cataract. Concomitant medication included citalopram hydrobromide (CITALOPRAM SANDOZ), morphine hydrochloride (MORFIN ABCUR), acetylsalicylic acid (TROMBYL), latanoprost (MONOPROST), midazolam hydrochloride (MIDAZOLAM ACCORD) , urea (CANODERM), furosemide (FURIX [FUROSEMIDE]), cyanocobalamin (BEHEPAN [CYANOCOBALAMIN]), gabapentin (GABAPENTIN ACCORD), folacin [folic acid] (FOLACIN [FOLIC ACID]) , metoprolol succinate (METOPROLOL ORION), brinzolamide (AZOPT), fentanyl (FENTANYL MYLAN), oxycodone hydrochloride (OXYNORM). On an unspecified date in Dec2020, the patient experienced wheeze, and dead 45 minutes after the vaccination. The patient died on an unspecified date Dec2020. An autopsy was not performed. Course of events: The patient developed thick phlegm in throat and mouth, she had difficult to swallow and wheezing which was discovered 45 minutes after the vaccination with Comirnaty. According to the reporter no signs of anaphylaxis but the patient received Jext 300 micrograms subcutaneously in her thigh and 10 tablets of Betapred dissolved in water, she also received Robinul 0,2 mg/ml injection 1 ml subcutaneously. The patient was put in prone side position with elevated head end but died within 5 minutes. According to the report was the ultimate cause of the woman''s death was probably heart insufficiency and breathing difficulties. Report assessed as serious, death.; Reported Cause(s) of Death: Heart insufficiency; Breathing difficult


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