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This is VAERS ID 1215614

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1215614
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Electrocardiogram ST segment elevation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Essential hypertension; Hypothyroidism
Diagnostic Lab Data: Test Date: 2021; Test Name: ECG; Result Unstructured Data: Test Result:ST-T segment elevation
CDC 'Split Type': SEPFIZER INC2021389525

Write-up: Chest pain; ST-T segment elevation; This is a spontaneous report downloaded from the Agency Regulatory Authority-WEB (Regulatory Authority report number: SE-MPA-2021-024468). A contactable physician (contactable through Regulatory Authority only) reported that an 84-year-old female patient received BNT162B2 (COMIRNATY, Lot number: EP2166; Expiration date was not reported), intramuscular in Mar2021 as a single dose for COVID-19 immunization. Medical history included essential hypertension and hypothyroidism; both were unknown if ongoing. The patient''s concomitant medications were not reported. In Mar2021, 8 days after the vaccination, the patient had chest pain. The patient did not seek medical attention, then called the health center a week later, and was referred to the emergency room. The patient''s electrocardiogram (ECG) in Mar2021 ST-T segment elevation. The patient had underwent percutaneous coronary intervention for the reported events. The patient had died on an unspecified date in 2021 after two days of hospitalization. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Chest pain; ST-T segment elevation

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