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This is VAERS ID 1173491

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1173491
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-01
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Brain herniation, Cerebral haemorrhage, Computerised tomogram head, Coma scale

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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? No
Previous Vaccinations:
Other Medications: PENTACARINAT; ZOLEDRONIC ACID; PRADAXA; BRICANYL; KALCIPOS-D; LIXIANA; IMBRUVICA; ACICLOVIR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Artificial cardiac pacemaker user; Atrial fibrillation; AV block; Chronic lymphocytic leukaemia
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: coma scale; Result Unstructured Data: Test Result:RLS 7-8*; Comments: RLS 7-8* (reaction level scale), wide light-stiff pupils *RLS 7 Unconscious. Stereotype stretching movement in pain, RLS 8, Unconscious, No reaction to pain stimulation; Test Date: 202103; Test Name: Brain CT; Result Unstructured Data: Test Result:intracranial haemorrhage; Comments: Brain CT shows fresh intracranial haemorrhage with midline displacement and incipient transstentorial herniation
CDC 'Split Type': SEPFIZER INC2021347525

Write-up: Intracerebral haemorrhage; transstentorial herniation; This is a spontaneous report received from a contactable physician downloaded from the regulatory authority. The regulatory authority report number is SE-MPA-2021-023033, Safety report unique identifier SE-MPA-1616598643286. An 81-year-old male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration in Mar2021 (Batch/Lot Number: unknown) as single dose for covid-19 immunisation. Medical history included chronic lymphocytic leukaemia from an unknown date and unknown if ongoing, Artificial cardiac pacemaker user from an unknown date and unknown if ongoing due to atrioventricular block, atrial fibrillation from an unknown date and unknown if ongoing. Previous drug reactions, drug rash of trimetoprim-sulfa and rash of lamisil. Concomitant medications included pentamidine isethionate (PENTACARINAT) taken for an unspecified indication from 20Jan2021 to an unspecified stop date; zoledronic acid taken for an unspecified indication from 15Jan2020 to an unspecified stop date; dabigatran etexilate mesilate (PRADAXA) taken for an unspecified indication, start and stop date were not reported; terbutaline sulfate (BRICANYL) taken for an unspecified indication from 20Jan2021 to an unspecified stop date; calcium carbonate, colecalciferol (KALCIPOS-D) taken for an unspecified indication, start and stop date were not reported; edoxaban tosilate (LIXIANA) taken for an unspecified indication from 23Dec2020 to an unspecified stop date; ibrutinib (IMBRUVICA) taken for an unspecified indication from 18Feb2021 to an unspecified stop date; aciclovir taken for an unspecified indication from 20Jan2021 to an unspecified stop date. The patient experienced intracerebral haemorrhage in Mar2021. Described by the reporter, the patient was vaccinated at 10 am. Found unconscious in the home at 10 p.m. When the patient arrived at the emergency room, RLS 7-8* (reaction level scale), wide light-stiff pupils (RLS 7 Unconscious. Stereotype stretching movement in pain, RLS 8, Unconscious, No reaction to pain stimulation.). Brain CT showed fresh intracranial haemorrhage with midline displacement and incipient transstentorial herniation. The patient died during the night in Mar2021.Outcome: Fatal. Report assessed as serious, death. It was unknown if an autopsy was performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Intracerebral haemorrhage; transstentorial herniation

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