National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1379816

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1379816
VAERS Form:2
Age:75.0
Sex:Female
Location:Foreign
Vaccinated:2021-04-16
Onset:2021-04-17
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiogenic shock, Dyspnoea, Fibrin D dimer, Myocardial infarction, Platelet count, Pulmonary oedema, Troponin T, Platelet factor 4, Inappropriate schedule of product administration, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-18
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: Fibrin D dimer; Result Unstructured Data: Test Result:Raised; Test Date: 202104; Test Name: Platelet count; Result Unstructured Data: Test Result:363; Comments: lowest platelet count after vaccine; Test Name: Platelet factor 4; Result Unstructured Data: Test Result:Anti-PF4 antibodies were not identified; Test Name: COVID-19 virus test; Test Result: Negative ; Test Name: Troponin T; Result Unstructured Data: Test Result:UNKNOWN
CDC 'Split Type': GBPFIZER INC2021620097

Write-up: Myocardial infarction; pulmonary oedema; cardiogenic shock; received the 2nd dose on 16Apr2021, 78 days from 1st dose; Increased shortness of breath; This is a spontaneous report received from a contactable physician from the Regulatory Authority (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202105251206554760-ONMNM, Safety Report Unique Identifier GB-MHRA-ADR 25355943. A 75-year-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration on 16Apr2021 (Batch/Lot number was not reported) as single dose at the age of 75-year-old for covid-19 immunisation. The patient medical history and concomitant medications were not reported. No additional medical history, that relates to previous venous or arterial thromboses. The patient had no previous reactions to medications, especially heparin or anticoagulants. The patient had not confirmed or suspected autoimmune or inflammatory disease, including vasculitis. No history of, or current, malignancy and intracranial malignancy. No concurrent or recent intracranial infections. No recent surgical or medical interventions to the central nervous system (including lumbar puncture). No recent trauma/head injury. The patient previously took heparin. Vaccine history included: bnt162b2 (COMIRNATY) dose 1 on 28Jan2021 for COVID-19 immunisation. On an unspecified date the patient experienced myocardial infarction (death, medically significant), pulmonary oedema (death, medically significant), cardiogenic shock (death, medically significant). On 17Apr2021 the patient experienced increased shortness of breath (death, medically significant). The patient received the 2nd dose on 16Apr2021, 78 days from 1st dose (non serious). The course of events was as follows: Patient attended emergency department (ED) with shortness of breath on 17Apr2021 and passed away cause of death noted as: cardiogenic shock, pulmonary oedema and myocardial infarction. The patient underwent lab tests and procedures which included: fibrin D dimer: raised on 17Apr2021, platelet count: 363 (lowest platelet count after vaccine) in Apr2021, platelet factor 4: anti-pf4 antibodies were not identified, Sars-cov-2 test: negative, troponin T: unknown. Patient has not tested positive for COVID-19 since having the vaccine. No haemorrhage was identified. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The reporting physician assessed that this report related to possible blood clots or low platelet counts. No follow-up Information on batch/lot number cannot be obtained attempts are possible. No further information expected. ; Reported Cause(s) of Death: Cardiogenic shock; Myocardial infarction; Pulmonary oedema

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1379816&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166