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This is VAERS ID 1316536

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1316536
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-04-14
Onset:2021-04-15
Submitted:0000-00-00
Entered:2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2246 / 1 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Acute pulmonary oedema, Asthenia, Bronchiectasis, Cardiac failure, Cough, Oedema, Oedema peripheral, Somnolence, Tachycardia, Secretion discharge

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-19
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: LYSANXIA; COLECALCIFEROL; EFFERALGAN [PARACETAMOL]; ELIQUIS; GAVISCON [ALGELDRATE;ALGINIC ACID;MAGNESIUM TRISILICATE;SODIUM BICARBONATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anorexia nervosa; Atrial fibrillation; Constipation; Embolism pulmonary; Hyperthyroidism
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FRPFIZER INC2021521996

Write-up: bronchial dilation; tachycardia; the edema of the lower limbs rises to the groin; acute pulmonary edema; asthenia; drowsiness; cough; mucus; Decompensation cardiac; edema of the lower limbs; This is as spontaneous report received from a contactable physician downloaded from the Regulatory Authority-WEB. The regulatory authority report number is FR-AFSSAPS-LY20213645, Safety report unique identifier FR-AFSSAPS-2021046232. A 92-years-old female patient received the first dose of BNT162B2 (COMIRNATY), intramuscular, administered in Arm Left on 14Apr2021 (Batch/Lot Number: EW2246) as single dose for COVID-19 immunisation. Medical history included anorexia nervosa for 5 years (39kg), constipation, pulmonary embolism, atrial fibrillation, hyperthyroidism. Patient had no historical COVID-19 infection. Concomitant medications included prazepam (LYSANXIA); colecalciferol; paracetamol (EFFERALGAN); apixaban (ELIQUIS 2.5); algeldrate, alginic acid, magnesium trisilicate, sodium bicarbonate (GAVISCON). On 14Apr2021: vaccination with a first dose of vaccine batch n EW2246, in the left arm. On 15Apr2021: appearance of edema of the lower limbs. On 17Apr2021: appearance of asthenia, drowsiness, cough, mucus and acute pulmonary edema, supported by a medical consultation by doctor. Prescription of a morphine patch. On 18Apr2021: in the morning, the edema of the lower limbs rises to the groin. On 19Apr2021: bronchial dilation and tachycardia. No indrawing or dyspnea. Patient experienced decompensation cardiac on 15Apr2021. The patient died on 19Apr2021. Cause of death reported as decompensation cardiac. It was unknown if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Decompensation cardiac

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