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This is VAERS ID 1377270

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First Appeared on 7/9/2021

VAERS ID: 1377270
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-05-18
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1C007A / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Blood glucose, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Bypass surgery; Diabetes; Overweight
Allergies:
Diagnostic Lab Data: Test Name: continuous blood sugar measurement; Result Unstructured Data: Test Result:no low blood sugar
CDC 'Split Type': DEPFIZER INC2021626869

Write-up: died suddenly a week after the second vaccination; This is a spontaneous report based on information received by Pfizer from Biontech [manufacturer control number: 59174], license party for Comirnaty. This is a spontaneous report from a contactable physician. A male patient of an unspecified age received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 07Apr2021 (Batch/Lot Number: ER 9480) as 1st dose, single, dose 2 via an unspecified route of administration on 18May2021 (Batch/Lot Number: 1C007A) as 2nd dose, single for covid-19 immunisation. Medical history included diabetes mellitus from an unknown date and unknown if ongoing , overweight from an unknown date and unknown if ongoing , bypass surgery from an unknown date and unknown if ongoing. The patient had no cough, no edemas. The patient''s concomitant medications were not reported. The patient experienced "died suddenly a week after the second vaccination" on an unspecified date. The patient underwent lab tests and procedures which included continuous blood glucose measurement: no low blood sugar. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: Sudden death, cause unknown

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