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This is VAERS ID 1427514

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1427514
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-05-28
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC889 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cerebral haemorrhage, Death, Nervous system disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-03
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: LANTUS; JANUVIA [SITAGLIPTIN]; ROSUVASTATIN; METFORMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': BEPFIZER INC2021688133

Write-up: Death; Nervous system disorder; Cerebral hemorrhage; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB BE-FAMHP-DHH-N2021-95019. A 69-years-old male patient received second dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 28May2021 (Lot Number: FC889) as single dose for covid-19 immunisation. Medical history included diabetes. Concomitant medications included insulin glargine (LANTUS); sitagliptin (JANUVIA); rosuvastatin; metformin hydrochloride (METFORMAX). The patient previously received first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on unspecified date (Lot /batch number unknown) as single dose for covid-19 immunisation. The patient experienced nervous system disorder, death and cerebral hemorrhage on 01Jun2021. The patient died on 03Jun2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Nervous system disorder; Cerebral hemorrhage; Death

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