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

This is VAERS ID 1469016

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Case Details

VAERS ID: 1469016 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-29
Onset:2021-05-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0779 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Cardio-respiratory arrest, Computerised tomogram, Drowning, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Slow movement; Tiredness
Allergies:
Diagnostic Lab Data: Test Date: 20210529; Test Name: Body temperature; Result Unstructured Data: Test Result:36.2 Centigrade; Comments: before vaccination; Test Date: 20210529; Test Name: CT; Result Unstructured Data: Test Result: Accumulated intra-bronchial fluid was noted. Cardiac; Comments: (after vaccination) Accumulated intra-bronchial fluid was noted. Cardiac hypertrophy was present. Traumatic injury was absent. Haemorrhage was absent. Brain injury was absent.
CDC Split Type: JPPFIZER INC2021758499

Write-up: The patient had an attack of loss of consciousness while in the bathtub; in a state of cardiopulmonary function arrest; Drowning; This is a spontaneous report from a contactable pharmacist received from the Regulatory Authority (RA). Regulatory authority report number is v21115670. The patient was an 81-year and 3-month-old male. Body temperature before vaccination was 36.2 degrees centigrade. Family history was unknown. Historical vaccine included influenza vaccine (details unknown). Concomitant medications were not reported. On 29May2021 at 09:00 (the day of vaccination), the patient received the first dose of BNT162b2 (COMIRNATY, Solution for injection, Lot number EY0779, Expiration date 31Aug2021) via an unspecified route of administration as a single dose for COVID-19 immunisation. On 29May2021 at 21:00 (12 hours after the vaccination), the patient had an attack of loss of consciousness. On the same date, the patient was in a state of cardiopulmonary function arrest, and died in drowning. On 29May2021 (the day of vaccination), the outcome of the events was fatal. It was not reported whether autopsy was done. The course of the events was as follows: The patient always hated hospitals and had made no hospital visits. He seemed to speak of being tired, and he moved slowly. On 29May2021 around 09:00 (the day of vaccination), the patient was vaccinated with the coronavirus vaccine. On the same day at 21:00 (12 hours after the vaccination), the patient had an attack of loss of consciousness while in the bathtub. An ambulance was called at 22:19. It arrived at the scene at 22:24 and at the reporting hospital at 22:56. The patient had no pulse, no respiration, no consciousness, and was in a state of cardiopulmonary function arrest. Light reflex was absent, and the pupils were dilated. No traumatic injury was noted. ADRENALINE INJECTION 0.1% SYRINGE 1 mL was injected three times, but the waveform was flat without change. At 23:30, death was confirmed. Blood was collected and computerised tomography (CT) was taken. Accumulated intra-bronchial fluid was noted. Cardiac hypertrophy was present. Traumatic injury was absent. Haemorrhage was absent. Brain injury was absent. The death was due to drowning. The reporting classified the event as serious (death) and assessed the causality between the event and BNT162b2 as unassessable. Other possible cause(s) of the event such as any other diseases was none (unknown). The reporting pharmacist commented as follows: Although the causal relationship was unknown, we made this report because of the death by drowning after the vaccination. Reported Cause(s) of Death: Drowning; The patient had an attack of loss of consciousness while in the bathtub; in a state of cardiopulmonary function arrest


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