National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1225056

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1225056
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-04
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2163 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac failure, Chronic obstructive pulmonary disease

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anaemia megaloblastic; Aortic stenosis; Arteriosclerotic cardiovascular disease; COPD; External carotid artery stenosis; Fibrillation atrial; Hypertension arterial; Sigmoid diverticulosis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESPFIZER INC2021398884

Write-up: Decompensation cardiac; COPD exacerbation; This is a spontaneous report from a contactable physician downloaded from the regulatory authority, regulatory authority number [ES-AEMPS-816748]. A 91-year-old male patient received the second dose of bnt162b2 (COMIRNATY, Lot Number: ep2163), intramuscular on 04Mar2021 as single dose for COVID-19 vaccination. Medical history included anaemia megaloblastic, hypertension arterial, aortic stenosis, fibrillation atrial, external carotid artery stenosis, arteriosclerotic cardiovascular disease, sigmoid diverticulosis, COPD (chronic obstructive pulmonary disease). The patient''s concomitant medications were not reported. The patient previously received the first dose of bnt162b2 (COMIRNATY) on 11Feb2021 for COVID-19 vaccination. The patient experienced COPD exacerbation on 10Mar2021 (6 days after the second vaccination) and decompensation cardiac on 20Mar2021 (16 days after the second vaccination). The patient died on an unspecified date. Cause of death were COPD exacerbation and decompensation cardiac. It was unknown if an autopsy was performed.; Reported Cause(s) of Death: COPD exacerbation; decompensation cardiac

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1225056&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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