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This is VAERS ID 1421782

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1421782
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-05
Onset:2021-05-21
Submitted:0000-00-00
Entered:2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 2 RA / OT

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Dyspnoea, Pyrexia, Vaccination failure, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-27
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: CVA
Allergies:
Diagnostic Lab Data: Test Date: 20210527; Test Name: body temperature; Result Unstructured Data: Test Result:39 Centigrade; Test Date: 20210521; Test Name: Covid-19 virus test; Test Result: Positive ; Comments: English variant.
CDC 'Split Type': FRPFIZER INC2021728762

Write-up: Vaccination failure; hyperthermia; dyspnoea; positive COVID-19 test; This is a spontaneous report from a contactable other health care professional downloaded from the WEB, regulatory authority number FR-AFSSAPS-2021067716. Case Summary and Reporter''s Comments Text: COVID-19 VACCINATION, Dose 1+Dose 2 , Confirmed vaccination failure. A 80-year-old male patient received second dose of BNT162B2 (COMIRNATY: Solution for injection, Lot Number: EJ6788, Expiration date: unknown), via intramuscularly, in right arm on 05Feb2021 as 2nd dose, single for COVID-19 immunization. Patient took his first dose of BNT162B2 (COMIRNATY: Solution for injection, Lot Number: EM0477, Expiration date: unknown), via intramuscularly, in right arm on 14Jan2021 as 1st dose, single for COVID-19 immunization. The patient medical history includes Cerebrovascular accident and concomitant medications were not reported. On 21May2021, the patient had PCR Covid-19 test positive (English variant) and on 27May2021 patient experienced, hyperthermia to 39 degree C and dyspnoea of sudden onset requiring 24-hour oxygen therapy. Later, the same day patient died with unknown cause of death. The patient underwent lab tests and procedures which included sars-cov-2 test resulted as positive on 21May2021 and body temperature 39 degree centigrade on 27May2021. The outcome of the events was fatal. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: unknown cause of death

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