National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 1113788



Case Details

VAERS ID: 1113788 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-06
Onset:2021-03-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-02
   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: DEPAKINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Epilepsy (was a fit and healthy person, with controlled epilepsy who had been fit free for a number of years.)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021262606

Write-up: Death; This is a spontaneous report from a contactable Consumer. This is a report received from the Regulatory Agency. Regulatory authority report number is GB-MHRA-WEBCOVID-202103091209028470, Safety Report Unique Identifier is GB-MHRA-ADR 24903452. A 41-year-old male patient received bnt162b2, first dose on 18Jan2021 and second dose on 06Feb2021 via an unspecified route of administration at single dose for COVID-19 immunisation. Medical history included epilepsy from an unknown date. The deceased was a fit and healthy person, with controlled epilepsy who had been fit free for a number of years. Patient has not had symptoms associated with COVID-19, patient was not enrolled in clinical trial. Concomitant medication included sodium valproate (DEPAKINE) for Epilepsy. The patient experienced death on 02Mar2021. The consumer reported that 3 weeks after receiving the second vaccination a healthy 41-year-old male passed away suddenly last week (on 02Mar2021). A post mortem was currently being carried out but this needed to be reported and logged as the consumer was not sure how a post mortem would see if the vaccine had any impact in his death. Patient has not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: No - Negative COVID-19 test on unknown date. The patient died on 02Mar2021. An autopsy was performed and results were not provided. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Death


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1113788

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166