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This is VAERS ID 1151860

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1151860
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: C-reactive protein, Haemoglobin, Platelet count, Vaccination failure, Ventilation/perfusion scan, White blood cell count, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-12
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiodepressive syndrome; Atrial fibrillation; Cardiac failure; COVID-19; Hepatic damage; Hypothyroidism; Ischemic stroke; Living in nursing home; Neutropenia; Thrombocytopenia
Allergies:
Diagnostic Lab Data: Test Name: CRP; Result Unstructured Data: Test Result:233; Test Name: Hb; Result Unstructured Data: Test Result:12; Test Name: platelets; Result Unstructured Data: Test Result:82000; Comments: thrombocytopenia; Test Name: lung scanner; Result Unstructured Data: Test Result:large areas of frosted glass scattered; Comments: large areas of frosted glass scattered around the 2 typical COVID19 lung fields. More than 50% attack; Test Name: leukocytes; Result Unstructured Data: Test Result:0.53; Comments: leucopenia
CDC 'Split Type': FRPFIZER INC2021333512

Write-up: COVID-19 pneumonia; Vaccination failure; This is a spontaneous report from a contactable physician from the regulatory authority-WEB FR-AFSSAPS-TO20211864. A 92 years old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EJ6789) on 11Feb2021 at single dose via an unspecified route of administration for COVID-19 immunization. Relevant medical history included Hepatic damage, Neutropenia, COVID-19, Anxiodepressive syndrome, Atrial fibrillation, Ischemic stroke, Thrombocytopenia, Hypothyroidism, Cardiac failure and living in nursing home. Concomitant medications were not reported. The patient received first dose of BNT162B2 on an unspecified date at single dose. On 06Mar2021 the was diagnosed with COVID-19 Pneumonia. Possible vaccination failure occurred. Covid 19 was evolving into severe form. Patient had an Emergency hospitalization on 11Mar2021 with respiratory distress. He was put under O2 15 liters. Performed lab test included CRP at 233, Hb at 12, leukopenia 0.53, thrombocytopenia 82 000. On the scanner: large areas of frosted glass scattered around the 2 typical COVID19 lung fields. More than 50% attack. The patient died on 13Ma2021 due to COVID-19 pneumonia and suspected vaccination failure. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19 pneumonia; vaccination failure

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