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This is VAERS ID 1428985

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First Appeared on 7/2/2021

VAERS ID: 1428985
VAERS Form:2
Age:88.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-06
Onset:2021-06-07
Submitted:0000-00-00
Entered:2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX3617 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Asphyxia, Body temperature, Drowning, Drug screen, Troponin, Investigation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-07
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: Diabetes mellitus; Dyslipidaemia; Late effects of cerebral infarction
Allergies:
Diagnostic Lab Data: Test Date: 20210606; Test Name: Body temperature; Result Unstructured Data: Test Result:37.2 Centigrade; Comments: before vaccination; Test Date: 202106; Test Name: Urine drug; Test Result: Negative ; Comments: autopsy; Test Date: 202106; Test Name: Cyan in oral cavity; Test Result: Negative ; Comments: autopsy; Test Date: 202106; Test Name: Spinal fluid; Result Unstructured Data: Test Result:colorless like water; Comments: autopsy; Test Date: 202106; Test Name: Myocardial troponin test; Test Result: Positive ; Comments: autopsy
CDC 'Split Type': JPPFIZER INC2021691238

Write-up: This is a spontaneous report from a contactable physician. Regulatory authority report number is v21113722. The patient was an 88-year and 1-month-old female. On 06Jun2021 at 15:33 (the day of vaccination), the patient received the second dose of BNT162b2 (COMIRNATY, Solution for injection, Lot number EX3617, Expiration date 31Aug2021) via an unspecified route of administration at age of 88-year-old as a single dose for COVID-19 immunization. Body temperature before vaccination was 37.2 degrees centigrade. Family history was not reported. Medical history included diabetes mellitus, dyslipidaemia, and late effects of cerebral infarction. The patient''s concomitant medications were not reported. On an unspecified date, the patient previously received the first dose of BNT162b2 (COMIRNATY, Lot# and expiration date were not reported) for COVID-19 immunisation. On 07Jun2021 from around 20:00 to 24:00 (estimation) (1 day after the vaccination), the patient experienced drowning during bathing. On 07Jun2021 (1 day after the vaccination), the outcome of the event was fatal. The course of the event was as follows: The patient lived alone, supported herself, and worked in fields a little. The patient normally visited another hospital (for diabetes mellitus, dyslipidaemia, late effects of cerebral infarction, and others). On 07Jun2021 in the morning, the patient served a gardener a cup of tea (when the patient was last seen). On 09Jun2021, a neighbor didn''t see the patient and became suspicious, for which the neighbor visited the patient and found the patient submerged in bathtub and dead at home. Subsequently, autopsy was conducted by the police and the reporting physician witnessed the examination. Findings included decomposition coloration of the trunk, chest compression, manifestation of bubbles in the oral cavity, and swelling and desquamation of the skin of hands and feet. On the other hand, no abnormality was observed in spinal fluid which was colorless like water, drug in urine which was tested was negative, and cyan in oral cavity which was tested negative. Myocardial troponin test was positive but was not taken into account (according to the investigation by the police). Based on the above, it was considered as death due to asphyxia by aspirating water. The reporting physician classified the event as serious (death) and assessed that the causality between the event and BNT162b2 as unassessable. Other possible cause of the event such as any other diseases was the presence of multiple underlying diseases. The reporting physician commented as follows: Cause of drowning was unknown. ; Reported Cause(s) of Death: drowning during bathing; asphyxia by aspirating water; Autopsy-determined Cause(s) of Death: asphyxia by aspirating water

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