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This is VAERS ID 1211719

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1211719
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-17
Onset:2021-03-21
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER7812 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Chills, Malaise, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: NU-SEALS; FUROSEMIDE; RANEXA; PANTOPRAZOLE; PROLIA; COVERSYL [PERINDOPRIL ERBUMINE]; LIPITOR [ATORVASTATIN CALCIUM]; CARDICOR; ZOPITAN; AVODART; NEURONTIN; XATRAL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Angina pectoris; Benign prostatic hyperplasia; CABG; Congestive cardiac failure; Coronary arterial stent insertion; Coronary artery disease (cor artery disease and stents); Gastrooesophagitis; Heart failure; Hypertension; Neuropathy; Osteoarthritis; Osteoporosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': IEPFIZER INC2021370907

Write-up: DIED SUDDENLY; SHIVERY; UNWELL; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB. This is a report received from Regulatory Authority (RA) Regulatory authority number IE-HPRA-2021-070237. An 89 years old male patient received second dose of BNT162B2 (COMIRNATY, Lot Number: ER7812) via an unspecified route of administration on 17Mar2021 at single dose for COVID-19 immunisation. Medical history included coronary artery disease "cor artery disease and stents", hypertension, coronary arterial stent insertion, gastrooesophagitis, osteoporosis, angina pectoris, heart failure, neuropathy, osteoarthritis, CABG, benign prostatic hyperplasia and congestive cardiac failure. Historical vaccine was reported as first dose of Comirnaty on 17Feb2021. Concomitant medications included acetylsalicylic acid (NU-SEALS) taken for coronary artery disease and stents, furosemide taken for cardiac failure, ranolazine (RANEXA) taken for angina, pantoprazole taken for gastrooesophagitis, denosumab (PROLIA) taken for osteoporosis, perindopril erbumine (COVERSYL) taken for hypertension, congestive cardiac failure, atorvastatin calcium (LIPITOR) taken for coronary artery disease, bisoprolol fumarate (CARDICOR) taken for congestive cardiac failure and angina, zopiclone (ZOPITAN) taken for hypnotic, dutasteride (AVODART) taken for benign prostatic hyperplasia (BPH), gabapentin (NEURONTIN) taken for neuropathy feet, alfuzosin hydrochloride (XATRAL) taken for benign prostatic hyperplasia (BPH), start and stop date were not reported. The patient experienced shivery and unwell on 21Mar2021 and died suddenly on 22Mar2021. The events were assessed as serious (death). It was reported that the patient was well after vaccination. On the night of 21Mar2021, the patient was unwell and shivery. On 22Mar2021, at 6 am, the patient was found dead. It was reported that the patient died suddenly. The outcome of all the events was fatal. The Coroner was informed and a post mortem was advised. The patient died on 22Mar2021. It''s unknown if an autopsy was performed. The cause of death was shivery, unwell and died suddenly. The reporter outlined it was unclear if the death was vaccine related. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: SHIVERY; UNWELL; DIED SUDDENLY

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