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This is VAERS ID 1152870

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1152870
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4238 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Seizure, Ventricular fibrillation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ILPFIZER INC2021330151

Write-up: collapsed in the ER convolution and VF (Ventricular fibrillation); collapsed in the ER convolution and VF (Ventricular fibrillation); This is a spontaneous report from a contactable healthcare professional received via regulatory authority. A 51 years old male patient received the first single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EK4238) on an unknown date, for COVID-19 immunisation. Medical history included diabetes. Concomitant medications were not reported. On an unspecified date the patient collapsed in the ER convolution and VF (ventricular fibrillation), as reported. The events required hospitalization and were reported with a fatal outcome. The patient died on an unknown date. It was unknown if an autopsy was performed. No follow-up attempts possible. No information expected.; Sender''s Comments: Limited information does not allow a medically meaningful assessment for the events "collapsed in the ER convolution and VF (Ventricular fibrillation)". Details regarding the drug-event temporal association, complete medical history, concomitant medication, hospitalization summary and autopsy results are not provided. The case will be re-evaluated if more information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: convolution and VF (Ventricular fibrillation); convolution and VF (Ventricular fibrillation)

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