National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1298238

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1298238
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-23
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3620 / 2 LA / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiopulmonary failure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-14
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: SINTROM; EUTIROX; SOPAVI; CARDIOASPIRIN; ATENOLOL; GIANT; PANTORC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Coronary artery bypass (Coronary artery bypass surgery, mitral replacement and tricuspid plastic surgery in September 2020.); Hypertension pulmonary (Pulmonary hypertension caused by mitral stenosis treated surgically in September 2020); Mitral stenosis; Mitral valve replacement; Plastic surgery
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ITPFIZER INC2021491300

Write-up: Respiratory crisis appeared about 17 days after administration of 2nd dose; This is a spontaneous report from a contactable consumer or other non hcp downloaded from the Regulatory Authority (RA)-WEB, regulatory authority number IT-MINISAL02-721802. A 82-year-old female patient received second dose of BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot Number: ET3620), via an unspecified route of administration in left arm on 23Mar2021 at 16:45 as a single dose for Covid-19 immunization. Medical history included pulmonary hypertension (pulmonary hypertension caused by mitral stenosis treated surgically in September 2020), coronary artery bypass in 22Sep2020 (coronary artery bypass surgery, mitral replacement and tricuspid plastic surgery in September 2020). Concomitant medications included atenolol from an unspecified start date to 06Apr2021, acenocoumarol (SINTROM), levothyroxine sodium (EUTIROX) at a dose for 50 microgram (ug), atorvastatin calcium (SOPAVI) at a dose of 20 mg, acetylsalicylic acid (CARDIOASPIRIN) at a dose of 100 mg, amlodipine besilate, olmesartan medoxomil (GIANT) from an unspecified start date to 09Apr2021, pantoprazole sodium sesquihydrate (PANTORC) at a dose of 40 mg on an unspecified date, all for unknown indication. The patient received first dose of BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot Number: Unknown) via an unspecified route of administration on 03Mar2021, as a single dose for Covid-19 immunisation and experienced pneumonitis. On 09Apr2021, the patient experienced cardio-respiratory failure and event was described as respiratory crisis appeared about 17 days after administration of 2nd dose. The patient was hospitalized due to respiratory crisis and died on 14Apr2021. An autopsy was performed and the cause of death from autopsy was cardiogenic shock in a patient suffering from chronic ischemic heart disease with heart failure, acute renal failure on CRI. Reporter comment: Reporter / family member reports not having certainty of correlation to vaccination. No follow up attempt possible. No further information expected.; Reported Cause(s) of Death: cardio-respiratory failure; Autopsy-determined Cause(s) of Death: chronic ischemic heart disease; acute renal failure; cardiogenic shock

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1298238&WAYBACKHISTORY=ON


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