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This is VAERS ID 1121560

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1121560
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-04
Onset:2021-03-07
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-07
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: SPIRONOLACTON; CITALOPRAM; METOPROLOL SUCCINATE; FUROSEMIDE; MACROGOL; ELIQUIS; PERINDOPRIL ERBUMINE; HUMALOG; ABASAGLAR; COLECALCIFEROL
Current Illness: Atrial fibrillation; Dementia; Diabetes mellitus; Hypertension; Kidney failure; Peripheral vascular disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021283274

Write-up: Unexpected death 3 days after administration of the second vaccine.; This is a spontaneous report from a contactable physician downloaded from the Regalatory Authority NL-LRB-00468384. An 87-year-old female patient received BNT162B2 (COMIRNATY), dose 2 via an unspecified route of administration on 04Mar2021 (batch/Lot Number: EP9598) as single dose for COVID-19 immunisation. Medical history included ongoing hypertension, ongoing peripheral vascular disease, ongoing diabetes mellitus, ongoing kidney failure, ongoing dementia, ongoing atrial fibrillation. Historical vaccine included first dose of bnt162b2 on 03Feb2021 for COVID-19 immunisation. Concomitant medications included spironolactone, citalopram, metoprolol succinate, furosemide, macrogol, apixaban (ELIQUIS), perindopril erbumine, insulin lispro (HUMALOG), insulin glargine (ABASAGLAR) and colecalciferol, all taken for an unspecified indication, start and stop date were not reported. The patient experienced unexpected death 3 days after administration of the second vaccine. Patient was found lifeless in bed on 07Mar2021 at 07:45 am. It was not reported if an autopsy was performed. Outcome of the event was fatal. Reporter comment: BioNTech / Pfizer vaccine (Comirnaty). Past drug therapy BioNTech/Pfizer vaccine (Comirnaty): yes Date: 03Feb2021. Unexpected death 3 days after administration of the second vaccination. Additional information ADR: She was found lifeless in bed on 07Mar at 07:45. Had known hypertension, atrial fibrillation, renal failure, diabetes mellitus and dementia. Additional information ADR: Woman was found lifeless in bed on 07Mar at 07:45 am. She was known with hypertension, atrial fibrillation, renal failure, diabetes mellitus and dementia. She had no side effects such as fever or malaise on 04Mar-07Mar. She had eaten well on the evening of 06Mar and had been nursed to bed in good condition. Confounding factors: Atrial fibrillation, renal insufficiency, peripheral vascular disease, hypertension, diabetes mellitus insulin dependent. Previous COVID-19 infection: No. No follow-up attempts possible. No further information expected.; Sender''s Comments: The event of sudden death is assessed as related until sufficient information is available to confirm an unrelated cause of death.; Reported Cause(s) of Death: unexpected death

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