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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||ET3674 / 2||- / -|
Administered by: Other Purchased by: ??
Symptoms: Septic shock, Acute kidney injury, SARS-CoV-2 test
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Current Illness: Adipositas per magna; Arterial hypertension; Chronic diarrhea; Chronic renal insufficiency (stage III); Hypochromic microcytic anemia; Ulcer of lower limbs, excl decubitus ulcer; Urinary tract infection
Preexisting Conditions: Medical History/Concurrent Conditions: Alcohol addiction
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 PCR test; Test Result: Positive
CDC 'Split Type': DEPFIZER INC2021590652
Write-up: Acute renal failure; Septic shock; This is a spontaneous report from a non-contactable physician downloaded from the regulatory authority-WEB, regulatory authority number DE-PEI-202100071817. A 68-year-old female patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 06Apr2021 (at age 68-years-old) (Batch/Lot Number: ET3674) as 2nd dose, 0.3 mL, single for covid-19 immunisation. The first dose was received on 25Feb2021 at age 68-years-old. Medical history included urinary tract infection from Mar2021 and ongoing, alcohol addiction, ongoing chronic kidney disease stage III, ongoing hypochromic anaemia, ongoing chronic diarrhea , ongoing arterial hypertension, ongoing Adipositas per magna, and ongoing ulcer of lower limbs, excl decubitus ulcer. The patient''s concomitant medications were not reported. The patient experienced acute renal failure and septic shock on 10Apr2021 which resulted in death. The patient underwent lab tests and procedures which included COVID-19 PCR test: positive on Jan2021. The patient died on 12Apr2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Acute renal failure; septic shock
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