National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1380443

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1380443
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-05-11
Onset:2021-05-12
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Abdominal pain, Body temperature, Body temperature decreased, Chills, Death, Hyperpyrexia, Malaise, Myalgia, Nervousness, Pain in extremity, Vomiting, Poor quality sleep

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TRAMADOL; METOPROLOL; CALCI CHEW; PANTOPRAZOLE; FLUOXETINE; LOSARTAN; IBEROGAST; METOCLOPRAMIDE; DIAZEPAM
Current Illness: Smoker (patient smoked a lot)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210512; Test Name: Body temperature; Result Unstructured Data: Test Result:35.4; Test Date: 20210515; Test Name: Body temperature; Result Unstructured Data: Test Result:40.5-42 Centigrade
CDC 'Split Type': NLPFIZER INC2021628348

Write-up: Death; Cold shivers; Feeling unwell; Fever: 40.5 to 42 degrees Celcius; Muscle pain; Vomiting; pain in the abdomen after vomiting; left arm pain; sleeping badly; Temperature 35.4 weak; Shaky; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number NL-LRB-00555741. A 60-year-old female patient received first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 11May2021 (Batch/Lot number was not reported) as 0.3 mL single dose for COVID-19 immunisation. Medical history included ongoing smoker (patient smoked a lot). The patient did not experienced COVID-19 prior vaccination. Concomitant medications included tramadol (formulation: capsule, strength: 50 mg); metoprolol (formulation: modified-release tablet, strength: 50 mg); calcium carbonate (CALCI CHEW, formulation: chewable tablet, strength: 1.25 g); pantoprazole (formulation: gastro-resistant tablet, strength: 40 mg); fluoxetine (formulation: dispersible tablet, strength: 20 mg); losartan (formulation: film-coated tablet, strength: 50 mg); angelica archangelica root/carum carvi fruit/chelidonium majus herb/glycyrrhiza glabra root/iberis amara/matricaria recutita flower/melissa officinalis leaf/mentha x piperita leaf/silybum marianum fruit (IBEROGAST); metoclopramide (formulation: tablet) and diazepam (formulation: tablet, strength: 10 mg), all concomitants were taken for an unspecified indication, start and stop date were not reported. The patient experienced cold shivers on 15May2021, shaky on 12May2021, feeling unwell on 15May2021, temperature 35.4 weak on 12May2021, muscle pain on 15May2021, vomiting, fever: 40.5 to 42 degrees Celsius on 15May2021, pain in the abdomen after vomiting on 12May2021, all with fatal outcome and left arm pain, sleeping badly both on 12May2021 with outcome of unknown. The patient died on 25May2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected. Batch/Lot number cannot be obtained.; Reported Cause(s) of Death: Death; shivers; Shaky; Feeling unwell; Temperature 35.4 weak; Muscle pain; Vomiting; Fever: 40.5 to 42 degrees Celcius; pain in the abdomen after vomiting

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1380443&WAYBACKHISTORY=ON


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