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

This is VAERS ID 1225064



Case Details

VAERS ID: 1225064 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-22
Onset:2021-02-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6790 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Dizziness, General physical health deterioration, Mobility decreased, Nausea, Poor quality sleep
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-09
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LINATIL; ELIQUIS; HUMIDOSE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anticoagulant therapy; Cardiac pacemaker insertion (insertion of a permanent VV1 pacemaker); Gallstones removal (gallstone removal, monitored from 2002 onwards); Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: FIPFIZER INC2021398633

Write-up: Unknown cause of death; Mobility decreased; Sleep restless; Nausea; Dizziness; General physical health deterioration; This is a spontaneous report from a contactable consumer downloaded from a regulatory authority-WEB, regulatory authority number FI-FIMEA-20211659. An 88-year-old male patient received BNT162B2 (COMIRNATY), via an unspecified route of administration on 22Feb2021 (Batch/Lot Number: EJ6790) as single dose for COVID-19 immunisation. Medical history included VV1 pacemaker (cardiac pacemaker insertion) on 31Jan2020: insertion of a permanent VV1 pacemaker, gallstone removal from the beginning of 2020: "monitored from 2002 onwards", hypertension and anticoagulant therapy. Concomitant medications included enalapril maleate (LINATIL) taken for hypertension, start and stop date were not reported; apixaban (ELIQUIS) taken for anticoagulant therapy, start and stop date were not reported; calcium chloride dihydrate, potassium chloride, sodium chloride (HUMIDOSE) taken for an unspecified indication, start and stop date were not reported. On 23Feb2021, the patient experienced mobility decreased, sleep restless, nausea, dizziness and general physical health deterioration. The day after the vaccination there was difficulty moving due to dizziness, he had to take support from the walls while walking and had nausea and restless sleep. On 09Mar2021, he had difficulty getting out of bed. His overall condition deteriorated after vaccination. The patient died (unknown cause of death) on 09Mar2021. The results of the forensic autopsy research were not yet available. No follow-up attempts are needed. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death


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