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

This is VAERS ID 1121383



Case Details

VAERS ID: 1121383 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-24
Onset:2021-02-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Anaphylactic reaction, Blood gases, Depressed level of consciousness, Dyspnoea, Malaise, Oxygen saturation, Oxygen saturation decreased, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Amyotrophic lateral sclerosis
Allergies:
Diagnostic Lab Data: Test Date: 20210224; Test Name: Blood gases; Result Unstructured Data: Test Result:severe hypercapnic respiratory failure; Test Date: 20210224; Test Name: oxygen saturation; Test Result: 80 %
CDC Split Type: ESPFIZER INC2021283155

Write-up: This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB manufacturer report number ES-AEMPS-784368. A 51-year-old male patient received bnt162b2 (COMIRNATY), dose 1 at age of 51-year-old via unspecified route on 24Feb2021 (Lot Number: EP9598) at 0.3 mL, single for covid-19 immunization. Medical history included non-bulbar amyotrophic lateral sclerosis from 2015, under outpatient follow-up, no baseline respiratory involvement or need for non-invasive mechanical ventilation, peripheral muscle involvement. The patient''s concomitant medications were not reported. First dose of bnt162b2 vaccine was administered on 24Feb2021 and 4 hours later, coinciding after dinner, he presented with sudden dyspnoea, with subsequent vomiting, general malaise and decreased level of consciousness. Emergency medical services found desaturation of 80%, respiratory work, no skin alterations. Oxygen and hydrocortisone were administered and he was transferred to hospital emergency. On arrival at the emergency department with low level of consciousness and desaturation. Blood gases showed severe hypercapnic respiratory failure (not present at baseline). Resuscitation and non-invasive ventilation were attempted (patient with a therapeutic ceiling for the underlying disease and the patient''s wishes) and the patient finally succumbed. A causal relationship secondary to vaccine anaphylaxis cannot be ruled out. additional information: Vaccine LOT: EP9598. Tryptase test has not been performed. Patient dependent for all activities of daily living due to muscular deficit, but with no history of dysphagia, bronchial aspiration or dyspnoea. He was not a user of mechanical ventilation. The patient died on 24Feb2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected; Reported Cause(s) of Death: Acute Respiratory failure; Depressed level of consciousness; sudden dyspnoea; vomiting; general malaise; desaturation of 80%; secondary to vaccine anaphylaxis.


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