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This is VAERS ID 1304622

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1304622
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-04-10
Onset:2021-04-25
Submitted:0000-00-00
Entered:2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2246 / 1 RA / OT

Administered by: Other      Purchased by: ??
Symptoms: Loss of consciousness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-01
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 disease, unspecified
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ITPFIZER INC2021501426

Write-up: Administration of the first Pfizer vaccine dose on 10Apr2021. On 25Apr2021 he suddenly fainted and rescuers who intervened within 10 minutes tried to revive him for 30 minutes.; This is a spontaneous report from a contactable consumer downloaded from the Agency Regulatory Authority-WEB [IT-MINISAL02-722534]. A 76-year-old male patient received the first dose of BNT162B2 (COMIRNATY, Lot#: Ew2246) via intramuscular at 0.3 ml single on 10Apr2021 from 10:00 to 11:00 in right arm for COVID-19 immunisation. Medical history included heart disease. Concomitant medication was not reported. Administration of the first Pfizer vaccine dose on 10Apr2021. On 25Apr2021, Sunday morning, patient suddenly fainted and rescuers who intervened within 10 minutes tried to revive him for 30 minutes. The general practitioner, who had been contacted, excluded that it may have been caused by the vaccine. He hypothesized an ischemia, an embolism or rupture of the aorta. Patient suddenly lost consciousness and rescuers, who intervened within 10 minutes, tried to revive him for 30 Min, even with a defibrillator. Patient died in Apr2021. He took medications regularly and specific tests every 6 months. On 30Apr2021, the emergency report sent by the reporter who contacted communicates: No autopsy was performed because he died at home and the doctor who declared the death did not ask us for anything. The outcome of event was fatal. Reporter comment: heart disease No follow-up attempts possible. No further information expected.; Reporter''s Comments: heart disease; Reported Cause(s) of Death: lost consciousness

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