National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1381508

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1381508
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Vaccination failure, COVID-19

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:
Current Illness: Extranodal marginal zone B-cell lymphoma (MALT type) stage IV (according to Ann Arbor: ongoing chemotherapy with 2021 obinutuzumab and ibrutinib)
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': ATPFIZER INC2021627610

Write-up: Covid, severe disease on 01May2021; Vaccination failure; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number AT-BASGAGES-2021-28994. A 62-years-old male patient received BNT162B2 (COMIRNATY; Solution for injection; Batch/Lot number was not reported), dose 2 intramuscular on 21Mar2021 as single dose and dose 1 via an unspecified route of administration on 21Feb2021 as single dose for covid-19 immunisation. Medical history included ongoing extranodal marginal zone B-cell lymphoma (MALT type) stage IV (according to (city name): ongoing chemotherapy with 2021 obinutuzumab and ibrutinib). Concomitant medication(s) included ibrutinib; obinutuzumab (IBRUTINIB;OBINUTUZUMAB) for chemotherapy from 2021. The patient experienced vaccination failure, other, Covid, severe disease on 01May2021. The patient died on an unspecified date. It was not reported if an autopsy was performed. This serious spontaneous report was received from a physician. The outcome for events vaccination failure and Covid, severe disease on 01May2021 was fatal. Sender Comment: The report is for a patient. No mail was sent to reporters! No follow-up attempts are possible, information on batch/lot number cannot be obtained.; Sender''s Comments: Based on temporal association, the causal relationship between BNT162B2 and the events cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available.; Reported Cause(s) of Death: Covid, severe disease on 01May2021

New Search

Link To This Search Result:

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