National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/12/2021 release of VAERS data:

This is VAERS ID 1380074

Government Disclaimer on use of this data



Case Details

VAERS ID: 1380074 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-18
Onset:2021-04-04
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2166 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Neoplasm progression
SMQs:, Malignancy related conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: SANDOSTATIN LAR; TEMOZOLOMIDE ACCORD
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cecal cancer; Endometrial adenocarcinoma; Hiatus hernia; Hypertension; Hysterectomy; Liver adenocarcinoma; Meningioma
Allergies:
Diagnostic Lab Data:
CDC Split Type: HUPFIZER INC2021628083

Write-up: Death/the adverse event as related to the patient''s primary diseases (cancer with metastases); This is as spontaneous report received from a contactable physician downloaded from the Agency Regulatory Authority-WEB. The regulatory authority report number is HU-OGYI-345421. A 78-year-old female patient received BNT162b2 (COMIRNATY), intramuscular, administered in left arm, on 18Mar2021 (Batch/Lot Number: EP2166) as 2nd single dose, at 0.3 ml, for COVID-19 immunisation. Medical history included cecal, liver and endometrial adenocarcinoma, hypertension, meningioma, hysterectomy and hiatus hernia. Concomitant medications included octreotide acetate (SANDOSTATIN LAR) from 25Mar2021, and temozolomide (TEMOZOLOMIDE ACCORD) from 24Feb2021. The first dose of BNT162b2 was administered on 25Feb2021. This case concerns the occurrence of death after BNT162b2 second injection. The patient was hospitalized on 29Mar2021 because of severe agranulocytosis and bleeding. The patient received antibiotics, GSF and thrombocyte transfusion. Her condition temporarily got better, but then it started to deteriorate. Later, pulmonary edema occurred. On 04Apr2021 at 9:00 the patient passed away. An autopsy was not performed. The event reported was ''death'' with no cause of death specified. Further information is not expected. Sender''s Comments: The reporter physician assessed the adverse event as related to the patient''s primary diseases (cancer with metastases), therefore the causal relationship is unlikely between the suspected drug and the event of death. The case is considered serious because the outcome was fatal. Further information is not expected. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death/the adverse event as related to the patient''s primary diseases (cancer with metastases)


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1380074


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