National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

This is VAERS ID 1113851



Case Details

VAERS ID: 1113851 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-18
Onset:2021-02-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GLICLAZIDE; MACROGOL; TEMAZEPAM; CALCIUMCARBONAAT; ENALAPRIL; METFORMIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NLPFIZER INC2021256535

Write-up: Pneumonia; Dyspnoea; This is a spontaneous report downloaded from the regulatory authority-WEB NL-LRB-00460560. A contactable physician reported that a 87-years-old female patient started to receive bnt162b2 (COMIRNATY), via an unspecified route of administration on 18Feb2021 at 1 DF, single for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included gliclazide (GLICLAZIDE), macrogol (MACROGOL), temazepam (TEMAZEPAM), calciumcarbonaat (CALCIUMCARBONAAT), enalapril (ENALAPRIL), metformin (METFORMIN). The patient experienced dyspnoea on 22Feb2021, pneumonia on an unspecified date on 25Feb2021. The patient died from the events on an unknown date. It was not reported if an autopsy was performed. Dyspnoea started 4 days after vaccination, 7 days after vaccination the dyspnoea worsened and the patient developed pneumonia. The decision was made to not treat the pneumonia and to start palliative sedation. No follow-up attempts are possible; information about lot/batch number cannot be obtained; Reported Cause(s) of Death: Dyspnea; pneumonie


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1113851

Government Disclaimer on use of this data


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