National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1435194

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1435194
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-04-27
Onset:2021-05-07
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET6956 / 2 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Cerebral haemorrhage, Death, Loss of consciousness, Nervous system disorder, Oxygen saturation, Oxygen saturation decreased, Pleural effusion, Computerised tomogram thorax, Computerised tomogram head, Blood pressure measurement

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-09
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension; Nephropathy (since 2018); Type I diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: Acetabulum fracture (After car accident); Automobile accident; Diabetic retinopathy; Jaw fracture (After car accident); Maxillary antrum fracture (After car accident); Non STEMI
Allergies:
Diagnostic Lab Data: Test Date: 20210507; Test Name: blood pressure; Result Unstructured Data: Test Result:hypertension; Test Date: 20210507; Test Name: chest CT; Result Unstructured Data: Test Result:circulatory stagnation and pleural fluid in both s; Comments: circulatory stagnation and pleural fluid in both sides of the lung; Test Date: 20210507; Test Name: skull CT; Result Unstructured Data: Test Result:large haemorrhage in four cerebral ventricles in t; Comments: large haemorrhage in four cerebral ventricles in the brain; Test Date: 20210507; Test Name: oxygen saturation; Result Unstructured Data: Test Result:low oxygenation levels
CDC 'Split Type': HUPFIZER INC2021752055

Write-up: died; disturbed and unconscious/coma-like state; low oxygenation levels; large haemorrhage in four cerebral ventricles in the brain; chest circulatory stagnation and pleural fluid in both sides of the lung; severe neurological damage; This is a spontaneous report from a contactable physician downloaded from the WEB HU-OGYI-456321. A 36-year-old male patient received second dose of bnt162b2 (COMIRNATY) intramuscularly in the left arm on 27Apr2021 at 0.3 ml single (lot number: ET6956) for COVID-19 immunisation. Medical history included ongoing type I diabetes mellitus, diabetes retinopathy, nephropathy since 2018 and ongoing, non-STEMI in 2020, ongoing hypertension. In 2021, the patient had a car accident, which resulted in maxillary antrum fracture, mandibular fracture and acetabulum fracture. The patient''s concomitant medicinal products were not reported. The patient previously received first dose of bnt162b2 intramuscularly in the left arm on 23Mar2021 at 0.3 ml single (lot number: ET3620) for COVID-19 immunisation. The patient experienced died on 09May2021. The clinical course was reported follows: On 07May2021, in his home, the patient became disturbed and unconscious. The ambulance was called and the patient was found in a coma-like state with hypertension and low oxygenation levels. The patient received respiratory support and was transported to the hospital. In the hospital, skull CT and chest CT was initiated. The skull CT test results showed large haemorrhage in four cerebral ventricles in the brain. The chest CT showed chest circulatory stagnation and pleural fluid in both sides of the lung. The patient was sedated and intensive medicinal treatment was initiated. On 08May2021, the patient''s severe neurological damage was reported. On 09May2021, the patient died. Outcome of other events was unknown. It was unknown if autopsy was performed. Sender Comment: Death after vaccination with Comirnaty is not expected. TTO is 10 days until hospitalization. Dechallenge and rechallenge were not applicable. The causal relationship between the suspected drug and the event is considered not assessable per lack of information. The case is considered serious due to hospitalization and fatal outcome. No follow-up attempts possible. No further information expected.; Sender''s Comments: There was no information provided regarding cause of death, autopsy results and diagnostic studies. However, per company causality assessment guidance, the event of death with unknown cause is assessed as related until the cause of death is clarified and will be re-assessed based on additional data. Event death and the other reported events causal relationship with the patient underlying condition cannot be excluded and is therefore not related to the suspect drug BNT162B2. This case will be updated once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: died

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1435194&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166