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

This is VAERS ID 1226665



Case Details

VAERS ID: 1226665 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-26
Onset:2021-03-18
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Gait disturbance, Motor dysfunction
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiac pacemaker insertion
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITPFIZER INC2021398828

Write-up: Difficulty coordinating movements and speech difficulties; Difficulty coordinating movements and speech difficulties; Difficulty coordinating movements and speech difficulties; This is a spontaneous report from a contactable consumer or other non hcp downloaded from the Agency Regulatory Authority-WEB, regulatory authority number IT-MINISAL02-711634. An 84-year-old male patient received second dose of BNT162B2 (COMIRNATY; Solution for injection; Lot number: unknown) via intramuscular route of administration on arm right on 26Feb2021 at 0.3 ug dose as SINGLE DOSE for COVID-19 immunization. The patient medical history included cardiac pacemaker insertion from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. On 18Mar2021, the patient had difficulty in coordinating movements and speech difficulties (aphasia, gait disturbance and motor dysfunction) (death). The patient died on an unknown date and the outcome of all events reported as fatal. It was not reported/unknown if an autopsy was performed or not. No follow-up attempts possible. No further information expected. Information on lot and batch numbers cannot be obtained.; Reporter''s Comments: My father wore a pacemaker in his heart.


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