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This is VAERS ID 1435192

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1435192
VAERS Form:2
Age:65.0
Sex:Female
Location:Foreign
Vaccinated:2021-04-22
Onset:2021-05-13
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET6956 / UNK LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Acute respiratory failure, Chronic obstructive pulmonary disease, Lung cancer metastatic, Disease progression

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-15
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: SEEBRI BREEZHALER; BERODUAL; VENTOLIN [SALBUTAMOL]; FOSTER [BECLOMETASONE DIPROPIONATE;FORMOTEROL FUMARATE]; RETAFYLLIN
Current Illness: Advanced lung cancer (with multiple metastases); COPD; Decompensation cardiac
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HUPFIZER INC2021752052

Write-up: acute respiratory failure; advanced lung cancer with multiple metastases; advanced lung cancer with multiple metastases; COPD; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number is HU-OGYI-424021. This serious, spontaneous case was reported by a physician on 01Jun2021, concerning the occurrence of death after the use of Comirnaty concentrate for dispersion for injection (MAH: BioNTech Manufacturing). On 22Apr2021, the 65-year-old female patient received 0.3 ml Comirnaty concentrate for dispersion for injection (tozinameran; Lot number: ET6956, expiry date: Aug2021, intramuscularly, in the left upper arm) for COVID-19 immunisation. On 13May2021, the patient''s asphyxiation symptoms increased and was sent to the hospital. The patient was hospitalized. In the hospital, the patient was treated for respiratory failure but the fatal outcome of advanced lung cancer was unavoidable. The patient died on 15May2021 in the early hours. According to the autopsy report, the cause of death was acute respiratory failure. The patient''s primary diseases that contributed to the death was COPD and advanced lung cancer with multiple metastases. In the patient''s medical history, there is advanced lung cancer, COPD and cardiac decompensation. The patient''s concomitant medicinal products were Berodual (fenoterol, ipratropium bromide), Foster (beclometasone, formoterol), Seebri Breezhaler (glycopyrronium bromide), Retafyllin (theophylline) and Ventolin (salbutamol). No further information is expected. Senders comments: Death after vaccination with Comirnaty is not expected. TTO is 3 weeks until hospitalization. Dechallenge and rechallenge were not applicable. Due to the patient''s primary diseases, the causal relationship between the suspected drug and the events is considered not related. The case is considered serious due to hospitalization and fatal outcome Batch/ lot number: ET6956 No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: acute Respiratory failure; COPD; advanced lung cancer with multiple metastases; advanced lung cancer with multiple metastases; Autopsy-determined Cause(s) of Death: acute Respiratory failure

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