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

This is VAERS ID 1235105



Case Details

VAERS ID: 1235105 (history)  
Form: Version 2.0  
Age: 102.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER9480 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Blood pressure measurement, Body temperature, Computerised tomogram, Oxygen saturation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-16
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MINEBASE; THEOLONG; AMLODIPINE; TELMISARTAN
Current Illness: Pneumonia aspiration (Treatment with clarithromycin)
Preexisting Conditions: Medical History/Concurrent Conditions: Aortic valve incompetence; Aortic valve stenosis; Cardiac failure chronic; Hospitalization NOS; Tricuspid valve incompetence
Allergies:
Diagnostic Lab Data: Test Date: 20210415; Test Name: Blood pressure; Result Unstructured Data: Test Result:decreased; Test Date: 20210402; Test Name: Body temperature; Result Unstructured Data: Test Result:37.3 Centigrade; Comments: pyrexia; Test Date: 20210412; Test Name: Body temperature; Result Unstructured Data: Test Result:36.6 Centigrade; Comments: before vaccination; Test Date: 20210402; Test Name: CT; Result Unstructured Data: Test Result:Pneumonia aspiration; Test Date: 20210414; Test Name: SpO2; Test Result: 75 %
CDC Split Type: JPPFIZER INC2021425503

Write-up: Asthmatic attack; This is a spontaneous report from a contactable physician received from the regulatory authority. The regulatory authority report number is v21102060. A 102-year and 4-month-old female patient received the first dose of BNT162B2 (COMIRNATY, formulation: Solution for injection, Lot number ER9480, Expiration date 31Jul2021), via an unspecified route of administration on 12Apr2021 14:40 (at the age of 102-years and 4-months) as a single dose for COVID-19 immunization. Medical history included: ongoing pneumonia aspiration from 02Apr2021, cardiac failure chronic (aortic valve stenosis, aortic valve incompetence, tricuspid valve incompetence). On 24Mar2021, the patient was admitted to the hospital (hospitalization reason not specified). On 02Apr2021, the patient had pyrexia of 37.3 degrees Centigrade. Pneumonia aspiration was diagnosed based on the image of computed tomography (CT). Treatment with antibacterial drug of clarithromycin was started. The patient''s body temperature was 37.3 Centigrade on 02Apr2021, and before vaccination was 36.6 degree Centigrade on 12Apr2021. Concomitant medications included: clarithromycin (MINEBASE) from 02Apr2021, theophylline (THEOLONG), amlodipine, and telmisartan for an unspecified indication. On 12Apr2021 at 14:40 (the day of vaccination), the patient received the first dose of COMIRNATY. On 13Ap2021 around 21:00 (1 day after the vaccination), the patient experienced asthmatic attack. On 16Apr2021 (4 days after the vaccination) at 6:51, the patient died. The course of the event was as follows: On 13Apr2021 around 21:00 (1 day after the vaccination), intraoral sputum accumulation developed, and large volume of sputum was vacuumed. Moaning was noted but no wheezing was seen. On 14Apr2021 (2 days after the vaccination), the patient made reaction to verbal contact. At 18:40, labored respiration, moaning, and wheezing were noted. SpO2 decreased to 75%. Drugs including bronchodilator, steroid, and catecholamine were administered, but they were ineffective. Until 14Apr2021, the patient had no pyrexia. On 15Apr2021 (3 days after the vaccination), blood pressure decreased, and bradycardia developed. On 16Apr2021 at 6:51, the patient''s death was confirmed, and the patient left hospital mortality. The outcome of the event asthmatic attack was fatal. The reporting physician classified the event as serious (Death) and the causality between the event and BNT162b2 as unassessable. Other possible causes of the event such as any other diseases were bronchial asthma and cardiac failure.; Reported Cause(s) of Death: Asthmatic attack


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