National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1113975

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1113975
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-23
Onset:2021-02-24
Submitted:0000-00-00
Entered:2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Condition aggravated, Depressed level of consciousness, Dysphagia, Vomiting, Hypophagia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-03
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: Nausea (in week prior to vaccination); Vomiting (in week prior to vaccination, increase in antiemetics prescribed by GP on 17Feb2021)
Preexisting Conditions: Medical History/Concurrent Conditions: Metastatic neoplasm; Oral intake reduced
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': AUPFIZER INC2021265102

Write-up: decreased consciousness; trouble swallowing; further vomiting; further deceased intake; further vomiting and deceased intake; This is a spontaneous report received from the Regulatory authority. Regulatory authority report number AU-TGA-0000521302. A contactable other healthcare professional (HCP) reported that an 81-year-old (also reported as 82-year-old) female patient received the first dose of BNT162B2 (COMIRNATY, lot/batch number not reported) via an unspecified route of administration on 23Feb2021 at 4:30 p.m. at single dose for COVID-19 immunisation. Medical history included carcinoma in right thigh which was thought to have metastasised and general decline-in weeks prior (onset date unknown)- reviewed by General Practitioner (GP) on 10Feb2021 and family had advised they did not wish for her to be transferred to hospital, other medical history included decrease in oral intake from Feb2021, ongoing nausea and vomiting issues in week prior to vaccination (Feb2021) and increase in antiemetics prescribed by GP on 17Feb2021. Decline continued post vaccination with medications being withdrawn a few days post vaccination. Treatment for vomiting: Ongoing GP assessments. The patient''s concomitant medications were not reported. As per clinical care coordinator, the patient received vaccine on 23Feb2021 at 4.30pm. Had some vomiting 2 days earlier with some decrease in oral intake. Reasonably well morning of vaccine. Had discussed with GP and family and happy to proceed with vaccine. Then following day on 24Feb2021, the patient experienced further vomiting and deceased intake. Reviewed by GP on 28Feb2021, diet changed from thin fluids to thickened fluids as trouble swallowing. On 01Mar2021, the patient experienced decreased consciousness, only eye opening to touch, medications ceased and palliated. The patient passed away on 03Mar2021. It was not reported if an autopsy was performed. The outcome of events all reported as fatal. The causality was provided as "Causality possible". No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: further vomiting and deceased intake; further vomiting and deceased intake; trouble swallowing; decreased consciousness; further vomiting and deceased intake

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1113975&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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