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This is VAERS ID 1438978

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1438978
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-17
Onset:2021-01-19
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Pneumonia, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-23
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: Aortic stenosis; Dementia with Lewy bodies; Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 20210119; Test Name: COVID-19 virus test; Test Result: Positive
CDC 'Split Type': IEPFIZER INC2021758651

Write-up: broncho-pneumonia; COVID-19; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number IE-HPRA-2021-073779. An 83-year-old male patient received bnt162b2 (COMIRNATY, solution for injection), via unspecified route of administration on 17Jan2021 (batch/lot number and expiry date unknown) as dose number unknown, single for covid-19 immunization. Medical history included hypertension, aortic stenosis, dementia with lewy bodies from Mar2020. The patient''s concomitant medications were not reported. On 19Jan2021, the patient experienced covid-19. On an unspecified date, the patient experienced broncho-pneumonia. The physician informed that the patient experienced COVID-19 and pneumonia following vaccination with Comirnaty for COVID-19 immunization. On 17Jan2021, the patient was vaccinated with Comirnaty and two days later (19Jan2021), the patient experienced bronchopneumonia and tested positive for COVID-19. The patient died due to the events on 23Jan2021 (also reported as seven days after vaccine). It was unknown if an autopsy was performed. No follow-up attempts are possible. Information about batch no cannot be obtained.; Reported Cause(s) of Death: broncho-pneumonia; COVID-19

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