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This is VAERS ID 1165290

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1165290
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-16
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6789 / 1 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Abdominal pain lower, Asthenia, Cardiac arrest, Constipation, Dehydration, Fatigue, Malaise

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-19
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Constipation; General physical health deterioration; Weight loss
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FRPFIZER INC2021342419

Write-up: Cardiac arrest; Asthenia; malaise/feeling unwell; Abdominal pain/lower pelvic abdominal pain; constipation; exhaustion; dehydration; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number FR-AFSSAPS-BX20212258. A 75-year-old male patient received bnt162b2 (COMIRNATY), dose 1 intramuscular, administered in Arm Left on 16Mar2021 (Lot Number: EJ6789) as SINGLE DOSE for COVID-19 immunization. Medical history included constipation, weight loss and deterioration of the general condition from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient presented on day 1 after the 1st injection, had abdominal pain, then on day 2 asthenia, malaise and death following cardiac arrest, in a context of deterioration of the general condition which began 3 weeks before the vaccination and constipation 5 days before vaccination. The patient has not had COVID-19, and has not been tested. The patient had no medical follow-up for 10 years. No treatment in progress. Concept of deterioration of general condition with weight loss for 3 weeks before vaccination. On day 1 17Mar2021, the patient contacts his sister and informs her that he is suffering from abdominal pain. On day 2 18Mar2021, the patient goes to his sister because he feels bad. Call from doctor done. Per doctor consultation, the patient had lower pelvic abdominal pain, constipation for 7 days (therefore beginning 5 days before vaccination), no tachycardia or respiratory failure and no sign of major severity. The patient had notion of dehydration (signs not specified) in Mar2021, asthenia and exhaustion noted on the report card. Prescription of a symptomatic treatment for digestive purposes and a biological assessment to be done the next day. In the evening, the sister calls back on the 15th: because patient is very tired, can no longer climb the stairs, feeling unwell on 18Mar202. Mobilization of a team of ambulance attendants who observe gasp, then perform 4 electric shocks. Mobilization of an emergency service which arrives at around 1 am (night from day 2 to day 3): patient was in cardiac arrest on 19Mar2021. Has already benefited for 15 min from resuscitation maneuvers. Death noted. It was proposed to the family to perform an autopsy for scientific purposes, not immediately accepted (possible delay 72 hours). The patient died on 19Mar2021 due to cardia arrest. An autopsy was not performed. The outcome of the rest of the events was unknown. No follow-up attempts are possible; information about lot/batch number already obtained.; Reported Cause(s) of Death: Cardiac arrest

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