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This is VAERS ID 1226797

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1226797
VAERS Form:2
Age:85.0
Sex:Male
Location:Foreign
Vaccinated:2021-02-11
Onset:2021-02-11
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Coronary artery disease, Malaise

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: Heart failure; Respiratory disorder ((not specified))
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021399196

Write-up: acute coronary event/considering the medical history of the patient; Not feeling well; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB with regulatory authority number NL-LRB-00443919 and Safety Report Unique Identifier is NL-LRB-00498609. An 85-year-old male patient received bnt162b2 (COMIRNATY reported as COVID-19 VACCINE NOT SPECIFIED INJVLST), via an unspecified route of administration on 11Feb2021 (Lot Number: EJ6788) as a single dose for covid-19 immunisation. Medical history included respiratory disorder (not specified) and heart failure. The patient''s concomitant medications were not reported. This serious spontaneous report from a physician concerns a male aged 85 years, with malaise (death) following administration of covid-19 vaccine not specified injvlst (action taken: not applicable) for covid 19 immunization. The patient was resuscitated. The reporter described that another cause of death (acute coronary event) could not be excluded, considering the medical history of the patient. It was reported that the patient was not feeling well and acute coronary event on 11Feb2021 (also reported as 1 day after vaccination). Following death, the physician have been in contact with the medical examiner, there will be a report via mental health care to a regulatory authority. Given the history, another cause of death cannot be completely ruled out (acute coronary event). The patient died on an unspecified date. It was not reported if an autopsy was performed. Reporter comment''s: -unknown- Past drug therapy I don''t know: No BSN available: Yes -confounding factors- confounding factors: underlying heart failure, lung problems -COVID-19- Previous COVID19 infection: No -Other- diagnostic procedures: Resuscitation remarks report from: Following death I have been in contact with the medical examiner, there will be a report via mental health care to a regulatory authority. Given the history, another cause of death cannot be completely ruled out (acute coronary event) No follow-up attempts possible. No further information expected.; Reporter''s Comments: -unknown- Past drug therapy I don''t know:No BSN available:Yes -confounding factors- confounding factors: underlying heart failure, lung problems -COVID-19- Previous COVID19 infection:No -Other- diagnostic procedures:Resuscitation remarks report from: Following death I have been in contact with the medical examiner, there will be a report via mental health care to a regulatory authority. Given the history, another cause of death cannot be completely ruled out (acute coronary event); Reported Cause(s) of Death: malaise; acute coronary event/considering the medical history of the patient

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