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This is VAERS ID 1161399

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1161399
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-26
Onset:2021-02-26
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Pain, Incorrect route of product administration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-10
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: HUMULIN M3
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021334280

Write-up: Pain; Shortness of breath; received bnt162b2 orally; This is a spontaneous report from a contactable healthcare professional. This is a report received from the Agency Regulatory Authority (RA). Regulatory authority report number GB-MHRA-EYC 00244953. A 56-year-old male patient received bnt162b2 BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), oral on 26Feb2021 as single dose for COVID-19 immunisation. Medical history included type 2 diabetes mellitus. Concomitant medication included insulin human, insulin human injection, isophane (HUMULIN M3). Before the vaccine injection, the patient has shown no fatal illness that would have resulted in the cause of death. The vaccine as coursed illnesses and symptoms, including pain, shortness of breath, problems on 27Feb2021. Outcome of the event pain was reported as not recovered and for the event shortness of breath was reported as fatal. The patient died on 10Mar2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. Information about lot/ batch number cannot be obtained.; Reported Cause(s) of Death: shortness of breath

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