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This is VAERS ID 1165288

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1165288
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-19
Onset:2021-03-19
Submitted:0000-00-00
Entered:2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3620 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Amnesia, Blood pressure systolic, Computerised tomogram, Confusional state, Death, Disorientation, Electrocardiogram, Electroencephalogram, Epilepsy, Hypotension, Malaise, Blood pressure measurement

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-21
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: ELIQUIS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension arterial; Thrombosis venous deep
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: blood pressure; Result Unstructured Data: Test Result:113/80; Test Date: 202103; Test Name: systolic blood pressure; Result Unstructured Data: Test Result:90 mmHg; Test Date: 202103; Test Name: CT scan; Result Unstructured Data: Test Result:No bleeding; Test Date: 202103; Test Name: ECG; Result Unstructured Data: Test Result:sinus ECG; Test Date: 202103; Test Name: EEG; Result Unstructured Data: Test Result:Standby trace rather well organized for age; Comments: Standby trace rather well organized for age, correctly reactive. Collection of a slow fluctuating focus that is correctly reactive under the temporal, central and left parietal regions. Post-critical origin uncertain.
CDC 'Split Type': FRPFIZER INC2021342404

Write-up: patient was found dead in his sleep; malaise; hypotension; disoriented; confused; total amnesia of the facts, last memory goes back to the descent of his car; epileptic seizure; This is a spontaneous report from a contactable physician from the Agency Regulatory Authority-WEB, regulatory authority number FR-AFSSAPS-BR20210892. An 86-year-old male patient received bnt162b2 (COMIRNATY), dose 1 intramuscular on 19Mar2021 (Batch/Lot Number: ET3620) as single dose for covid-19 immunisation. Medical history included deep vein thrombosis, hypertension. Concomitant medications included apixaban (ELIQUIS) taken for an unspecified indication, start and stop date were not reported. Back from the vaccination around 3 p.m on 19Mar2021, patient found by witnesses, on the ground, disoriented and confused. Total amnesia of the facts, last memory goes back to the descent of his car with trace of bite of the tongue compatible with a probable epileptic seizure. No bleeding on CT scan, sinus ECG, first-line non-contributory blood assessment. Clinically in a state of post-critical confusion. No signs of neurological focus. Electroencephalography (EEG): Standby trace rather well organized for age, correctly reactive. Collection of a slow fluctuating focus that is correctly reactive under the temporal, central and left parietal regions. Post-critical origin uncertain. No epileptic figure. Transfer to short-term hospitalization unit for monitoring. On 20Mar2021, in the afternoon, the patient presented with malaise with hypotension without tachycardia, prolonged hypotension, having responded to a 500 ml of NaCl. No complaints expressed, no abnormality on neurological or cardiopulmonary examination. Decision to extend the 24-hour surveillance with a blood check scheduled for the morning of the 21st. Hourly blood pressure monitoring until midnight: no tachycardia; systolic blood pressure 90 mm Hg. Felt better after sleeping, discussion with the nursing team at 1:30 (last blood pressure check, BP 113/80), no discomfort expressed, eupneic, no pain, normal vigilance. Passage at 4:00: slept. On 21Mar2021, at 6 a.m., the patient was found dead in his sleep. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: patient was found dead in his sleep

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