National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 1213633



Case Details

VAERS ID: 1213633 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-02
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Angina pectoris, Asthenia, Back pain, Cardiac disorder, Death, Electrocardiogram, Electrocardiogram abnormal, Gallbladder disorder, Gastric ulcer, Gastrointestinal disorder, Gastrointestinal examination, Joint swelling, Myocardial infarction, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal ulceration (narrow), Gallbladder related disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-24
   Days after onset: 22
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart disease, unspecified ((ECG finding stable for long time)); Nonsmoker
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: ECG; Result Unstructured Data: Test Result:weak heart with respect to age; Comments: weak heart with respect to age; Test Date: 20210323; Test Name: ECG; Result Unstructured Data: Test Result:disarranged; Test Date: 202103; Test Name: Gastrointestinal examination; Result Unstructured Data: Test Result:gastro possibly normal
CDC Split Type: CZPFIZER INC2021389799

Write-up: weak heart; "disarranged" ECG; stomach ulcer; Death; Pain from abdominal to heart and back/stomach pain radiating to the heart and back; suspicion of heart attack or irritated gallbladder; Nausea; Pain from abdominal to heart and back/stomach pain radiating to the heart and back; Weakness; Swollen ankles; Pain from abdominal to heart and back/stomach pain radiating to the heart and back; suspicion of heart attack or irritated gallbladder; suspected of gastrointestinal problems; paler than usual; This is a spontaneous report from a contactable consumer downloaded from a regulatory authority- CZ-CZSUKL-21003462. A 90-year-old male patient received the first dose of bnt162b2 (COMIRNATY), via an unspecified route of administration on 02Mar2021 (Batch/Lot Number: Unknown) as single dose for covid-19 immunisation. Medical history included heart disease, unspecified (ECG finding stable for long time), nonsmoker and has no obesity with above average health condition. The patient''s concomitant medications were not reported. The patient experienced nausea, pain from abdominal to heart and back, weakness, and swollen ankles on Mar2021. The patient died on 24Mar2021. It was reported that the patient experienced sudden weakness, nausea, stomach pain radiating to the heart and back (patient had a suspicion of heart attack or irritated gallbladder after meal) 3 weeks after the vaccination with Comirnaty vaccine (Mar2021). The pain was not severe, rather unpleasant, suspected of gastrointestinal problems. The patient took Famosan for stomach ulcer (unspecified date), took commonly on prescription - pain subsided. He was happier but sicker and paler than usual and his ankles were swollen according to his daughter. The same problems were repeated the next day, Wednesday 23Mar2021, again in the afternoon. In the evening, at 6 PM, an ambulance was called just for affirmation. Ambulance finding was weak heart and "disarranged" ECG; he was transferred to intensive care unit. Gastrointestinal examination and ECG were performed, according to the physician he had a weak heart with respect to age, gastro possibly normal. The patient died on 24Mar2021. Therapeutic measures were taken as a result of nausea, and pain from abdominal to heart and back. The outcome of the events was unknown. The patient died on 24Mar2021 due to an unknown cause. An autopsy was not performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1213633

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166