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This is VAERS ID 1375484

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1375484
VAERS Form:2
Age:73.0
Sex:Male
Location:Foreign
Vaccinated:2021-05-06
Onset:2021-05-07
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-07
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: Atrial fibrillation; Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PLPFIZER INC2021616455

Write-up: Cardiac arrest; This is a spontaneous report received from a contactable consumer (friend of the patient''s daughter) downloaded from a regulatory authority-WEB PL-URPL-DML-MLP.4401.2.324.2021. A 73-year-old male patient received the second dose of BNT162b2 (COMIRNATY), intramuscularly on 06May2021 morning (at the age of 73-years-old) at 2nd dose, single for COVID-19 immunisation. Medical history included atrial fibrillation, hypertension. Concomitant medications were not reported. The patient previously received the first dose of BNT162B2 on an unspecified date for COVID-19 immunisation. The patient experienced cardiac arrest on 07May2021 around 21:00. The patient died due to the event on 07May2021. It was unknown if an autopsy was performed. Sender comment: Cardiac arrest is an unexpected adverse reaction for a vaccine. Considering the patient''s age, co-morbidities, it is not possible to conclude conclusively what contributed to the adverse reaction. The temporal relationship supports a cause and effect relationship. A regulatory authority assessed the notification as severe (death). Causality assessment: Source (unlisted), Method (unlisted), Result Possible. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: cardiac arrest

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