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 1226662



Case Details

VAERS ID: 1226662 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-01
Onset:2021-04-02
   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 ER9470 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Haematemesis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PERINDOPRIL; DELORAZEPAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; Sleep disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITPFIZER INC2021398771

Write-up: Vomiting/vomiting episode with traces of blood; Cardiac arrest; This is a spontaneous report downloaded from the regulatory authority-WEB [Regulatory authority number IT-MINISAL02-710856]. A contactable physician reported an 82-year-old female patient received the first dose of bnt162b2 (COMIRNATY), intramuscular administered on arm left on 01Apr2021 10:35 (Batch/Lot Number: ER9470; Expiration Date: 31Jul2021) as SINGLE DOSE for COVID-19 immunization. Medical history included arterial hypertension and sleep disorder (reported as sleeping). Concomitant medications included perindopril (PERINDOPRIL) taken for arterial hypertension and delorazepam (DELORAZEPAM) taken for sleep disorder (sleeping disorder) both taken since unknown therapy dates. On 02Apr2021 (reported as 24 hours after administration), the patient had vomiting episode with traces of blood. After access to the patient, she was transferred to perform esophago-gastro-duodenoscopy but died of the patient due to cardiac arrest on that same day of 02Apr2021. It was not reported if an autopsy was performed. The patient died due to vomiting and cardiac arrest. Sender''s comments: On 06Apr2021 request for a clinical report and if an autopsy examination was carried out. Reporter''s comment: death of the patient 24 hours after the administration of the vaccine. No follow-up attempts are possible. No further information is expected. ; Reporter''s Comments: death of the patient 24 hours after the administration of the vaccine.; Reported Cause(s) of Death: Vomiting/ vomiting episode with traces of blood; cardiac arrest


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1226662

Government Disclaimer on use of this data


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