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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1429203

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Case Details

VAERS ID: 1429203 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Blood gases, Cardiac arrest, Chest pain, Electrocardiogram
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes; Gout; Hyperlipidaemia; Hypertension; Obesity ((BMI 31) since several years (concluded by reporter as metabolic syndrome))
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: artery blood gasometry; Result Unstructured Data: Test Result:Lactate 17; Comments: Checking artery bloodgases, Lactate 17; Test Name: ECG; Result Unstructured Data: Test Result:still heart inspite of repeated doses of adrenalin; Comments: ECG shows still heart inspite of repeated doses of adrenaline and compressions.
CDC Split Type: SEPFIZER INC2021688250

Write-up: Deceased unknown cause, cardiac arrest; acute MI; Chest Pain; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB. This physician reported different events for both doses of Comirnaty for the same patient. This is the first of two reports. The regulatory authority report number for the first, serious report is [SE-MPA-2021-045669]. A 61-years-old male patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on Jun2021 (Batch/Lot Number: unknown) as DOSE 2, SINGLE for covid-19 immunisation. Medical history included diabetes from 2016 and ongoing, ongoing obesity: (BMI 31) since several years (concluded by reporter as metabolic syndrome), hyperlipidaemia from 2010 and ongoing, ongoing gout, hypertension from 2009 and ongoing. Historical vaccine included Comirnaty (covid-19 vaccines; batch/lot not provided), first dose administered on unknown date in 2021 and experienced chest pain on unknown date after the first dose of Comirnaty. The patient''s concomitant medications were not reported. The patient experienced deceased unknown cause, cardiac arrest, acute MI and chest pain (approx 1 hr after the second dose), all on Jun2021 with fatal outcome. The patient underwent lab tests which included blood gases: lactate 17 (Checking artery bloodgases, Lactate 17) on unknown date, electrocardiogram: shows still heart inspite of repeated doses of adrenaline and Lucas compressions on unknown date. The patient died on an unspecified date. An autopsy was not performed. Reported on the same day the patient experienced cardiac arrest in his home. Bystander CPR initiatally, initial rythm VF (ventricular flutter), defibrillated x6 and then asystolic. CPR continued for i 55 min. At admission to hospital intubated without spontaneous circulation an asystole on ECG. Ultrasound led pinprick in A. Femoralis and V.Femoralis and dministring 6F introducer. Checking artery bloodgases, Lactate 17. ECG shown still heart inspite of repeated doses of adrenaline and Lucas compressions. Patient was deceased on the same day as vaccination with dose two.According to the rapporteur several risk factors for cardiovascular disease are present, most likely cause of death is acute MI, but ECG was not assessable (no bearing rythm). Autopsy was not yet concluded. Report assessed as serious, death. Cause of Death was set as cardiac arrest, pending autopsy result. Treatment received for cardiac arrest and acute MI. No follow-up attempts are possible, information on batch number cannot be obtained.; Sender''s Comments: Linked Report(s) : SE-PFIZER INC-2021691873 the same patient, different dose and event; Reported Cause(s) of Death: Acute myocardial infarction; Cardiac arrest


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