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This is VAERS ID 1215613

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1215613
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Incorrect route of product administration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-25
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: CPAP; Hypothyreosis; Ischemic heart disease; Percutaneous coronary intervention; Pulmonary embolism; Sleep apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': SEPFIZER INC2021389516

Write-up: Cardiac arrest; comirnaty administered via subcutaneous; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB. The Regulatory Authority report number is SE-MPA-2021-023470, other case identifier number SE-MPA-1616707176996. A 78-year-old male patient received BNT162B2 (COMIRNATY, lot number and expiration date not reported), subcutaneous on 25Mar2021 as a single dose for COVID-19 immunisation. Medical history included ischemic heart disease, Hypothyreosis, sleep apnea uses CPAP (continuous positive airway pressure) at night, pulmonary embolism and previous percutaneous coronary intervention in 2005. The patient''s concomitant medications were not reported. According to a relative, the patient has been feeling well lately. On the same day that the patient was vaccinated with Comirnaty, on 25Mar2021, the patient experienced cardiac arrest in the evening. The patient died the same day despite CPR (cardiopulmonary resuscitation) for nearly 60 minutes. The patient died on 25Mar2021. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Cardiac arrest

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