National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 1412006



Case Details

VAERS ID: 1412006 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA2453 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Bedridden, Dysarthria, Pain in extremity, Thalamus haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPPFIZER INC2021659284

Write-up: haemorrhage brain/right thalamus haemorrhage; dysarthria; unable to get up normally; pain in the left upper limb; This is a spontaneous report from a contactable physician received from the regulatory authority. Regulatory authority report number is v21111780. The patient was an 85-year and 3-month-old male. Body temperature before vaccination was not provide. The patient''s family history was unknown and patient''s vaccine screening questionnaire (primary diseases, allergies, vaccinations and illnesses within the last one month, medications the patient was taking, past adverse effect history, growth status, etc.) included unknown, no fever occurred. On 03Jun2021 at 15:00 (the day of vaccination), the patient received the first dose of bnt162b2 (COMIRNATY, Solution for injection, Lot number FA2453, Expiration date 31Aug2021) at the age of 85-year-old via an unspecified route of administration as a single dose for COVID-19 immunization. Before 04Jun2021 at 08:30 (17 hours 30 minutes after the vaccination), the patient experienced haemorrhage brain. On 04Jun2021 at about 08:30 (17 hours 30 minutes after the vaccination), the patient was admitted to the hospital. The outcome of the event was not provide. The course of the event was as follows: On 03Jun2021, the first vaccination was carried out. The patient complained of pain in the left upper limb on the same night. On 04Jun2021 at about 08:30 a.m, when patient''s daughter spoke, the patient had dysarthria and was unable to get up normally. After observation, the symptoms did not improve, so asked for emergency aid. He was transferred to hospital and diagnosed as right thalamus haemorrhage. The reporting physician classified the event as serious (Hospitalized) and assessed the causality between the event and bnt162b2 as un-assessable. Other possible causes of the event such as any other diseases was hypertension. The reporting physician commented as follows: not provided.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1412006


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