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This is VAERS ID 1319092

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1319092
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-04-02
Onset:2021-04-05
Submitted:0000-00-00
Entered:2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2239 / 1 RA / OT

Administered by: Other      Purchased by: ??
Symptoms: Bradycardia, Cardiac arrest, Cardiovascular disorder, SARS-CoV-2 test, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-22
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: VALSACOR; METFOGAMMA; BISOBLOCK
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes mellitus; Hypertension; Hypothyroidism; Obesity; Ophthalmologic treatment; Rheumatological examination
Allergies:
Diagnostic Lab Data: Test Date: 20210405; Test Name: COVID-19 test; Test Result: Positive
CDC 'Split Type': HUPFIZER INC2021535755

Write-up: COVID-19 pneumonia; cardiovascular instability; bradycardia; asystole; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB HU-OGYI-282221. A 61-year-old female patient received bnt162b2 (COMIRNATY), intramuscular, administered in Arm Right on 02Apr2021 (Batch/Lot Number: EW2239) as 1st dose, 0.3ml single for covid-19 immunisation. Medical history included obesity, diabetes mellitus, hypothyroidism, hypertension, ophthalmological and rheumatology treatment. Concomitant medications included valsartan (VALSACOR), metformin hydrochloride (METFOGAMMA) and bisoprolol fumarate (BISOBLOCK). The patient experienced covid-19 pneumonia on 05Apr2021. The patient was hospitalized for covid-19 pneumonia from 16Apr2021. On 05Apr2021, the patient was tested positive to COVID-19 with a rapid test. On 16Apr2021, she was taken to the hospital by an ambulance with dyspnea. COVID-19 pneumonia was verified. On 22Apr2021, the patient experienced cardiovascular instability, bradycardia and asystole; resuscitation was unsuccessful. The patient underwent lab tests and procedures which included COVID-19 test: positive on 05Apr2021. The patient died on 22Apr2021 due to COVID-19 pneumonia. It was unknown if an autopsy was performed. The outcome of the other events was unknown. Sender Comment: COVID-19 pneumonia was detected 3 days after vaccination with COMIRNATY. Immunity did not develop within 3 days after vaccination. The causal relationship between the vaccine and the event is unlikely. The case is considered serious due to fatal outcome.; Reported Cause(s) of Death: COVID-19 pneumonia

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