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This is VAERS ID 1297380

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1297380
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-03
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Abdominal pain, Death, Pneumonia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: APIXABAN; CALCIUM CARBONATE; DUTASTERIDE; FOLIC ACID; FLUOXETINE; FUROSEMIDE; PRAVASTATIN; RIVASTIGMINE; TAMSULOSIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Aortic stenosis; Atrial fibrillation; Blood pressure high; Dementia; Enlarged prostate; Pseudoaneurysm; Squamous cell carcinoma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021453403

Write-up: Person died; pneumonia; Sudden respiratory symptoms; Abdominal pain; This is a spontaneous from a contactable consumer downloaded from the regulatory authority-WEB. This is a report received [RA} Regulatory authority report number [GB-MHRA-WEBCOVID-202104161642285520] with Safety Report Unique Identifier [GB-MHRA-ADR 25160155]. An 89-year-old male patient received the second dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot# EJ1688), via an unspecified route of administration on 03Jan2021 at single dose for COVID-19 immunisation. Medical history included dementia, aortic stenosis, Enlarged prostate, atrial fibrillation, hypertension (HTN), squamous cell carcinoma (SCC), pseudoaneurysm. Patient had not symptoms associated with COVID-19. Not had a COVID-19 test. Patient was not enrolled in clinical trial. Concomitant medications included apixaban taken from 25Mar2017 to an unspecified stop date; calcium carbonate (CALCIUM CARBONATE) taken from 26Feb2015 to an unspecified stop date; dutasteride taken from 10Jul2018 to an unspecified stop date; folic acid taken from 24Apr2015 to an unspecified stop date; fluoxetine taken from 26Feb2015 to an unspecified stop date; furosemide taken from 03Sep2016 to an unspecified stop date; pravastatin taken from 26Feb2015 to an unspecified stop date; rivastigmine taken from 26Apr2017 to an unspecified stop date; tamsulosin taken for prostatomegaly from 07Oct2018 to an unspecified stop date. On 16Jan2021, the patient experienced abdominal pain. On 29Jan2021, the patient experienced Sudden respiratory symptoms. On 31Jan2021, the patient experienced pneumonia. The patient''s hospitalization was prolonged as a result of abdominal pain. The events Abdominal pain, pneumonia, Sudden respiratory symptoms were assessed as serious (medically significant). The clinical course was reported as follows: Severe abdominal pain, hospitalised, no cause identified. Sudden respiratory symptoms 29Jan2021, antibiotics for LRTI. Diagnosed with EoL Pnemonia 31Jan2021. Palliative pathway started. Medications withdrawn. 02Feb2021, antibiotics and steroids prescribed. Assessed, no evidence of pneumonia. Recovering until 05Feb2021. Syringe driver inserted by DN. Person died on 18Feb2021. Patient has not tested positive for COVID-19 since having the vaccine. Therapeutic measures were taken as a result of pneumonia, and sudden respiratory symptoms (respiratory disorder). The patient died on 18Feb2021. It was not reported if an autopsy was performed. The outcome of the event abdominal pain was recovered on 18Jan2021, while unknown for the other events. On 18Feb2021, the person died. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Person died

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