National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1416305

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1416305
VAERS Form:2
Age:71.0
Sex:Male
Location:Foreign
Vaccinated:2021-05-29
Onset:2021-05-01
Submitted:0000-00-00
Entered:2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA8016 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Death, Fatigue, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-01
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:
Other Medications: GLICLAZIDE; METFORMIN; COVERSYL ARG; RIVAROXABAN; FUROSEMIDE; FERROUS FUMARATE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NLPFIZER INC2021699086

Write-up: tired; fever on the day of vaccination; he was found dead on 02Jun2021, possibly deceased 30May2021 or 31May2021; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority -WEB NL-LRB-00572085. A 71-year-old male patient received bnt162b2 (COMIRNATY) via an unspecified route of administration on 29May2021 (at the age of 71 years old) (Batch/Lot Number: FA8016) as 2nd dose, single for COVID-19 immunization. The patient medical history was not reported. No previous COVID-19 infection. Concomitant medications included gliclazide; metformin; perindopril arginine (COVERSYL ARG); rivaroxaban; furosemide; ferrous fumarate. The patient previously received the first dose of bnt162b2 on 24Apr2021 at 0.3ml single for COVID-19 immunization. The patient experienced unknown (death) in May2021 (30May2021 or 31May2021), fever on the day of vaccination (death) on 29May2021, tired (death) on 30May2021. Patient had fever (Saturday evening) on the day of vaccination. The next day his son called on Sunday around afternoon, son called (20 seconds), patient was tired and laying in bed. When his son could not reach him anymore, he went to his house on 02Jun2021, where he found him dead, possibly deceased on 30May2021 or 31May2021. Autopsy was done, no autopsy result available and at first glance there were no obvious cause of death found. Death, or causal relationship is not clear, according to sons evening post-vaccination fever. Outcome of the events was fatal. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: fever on the day of vaccination; tired; unknown

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1416305&WAYBACKHISTORY=ON


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