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This is VAERS ID 1588698

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/20/2021

VAERS ID: 1588698
VAERS Form:2
Age:89.0
Sex:Male
Location:Foreign
Vaccinated:2021-01-13
Onset:2021-01-17
Submitted:0000-00-00
Entered:2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Myocardial infarction, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Lung inflammation (pneumonia); Swallowing impaired (swallowing disorder)
Allergies:
Diagnostic Lab Data: Test Date: 20210117; Test Name: body temperature; Result Unstructured Data: Test Result:38.7 Centigrade; Comments: without pathological findings; Test Date: 20210117; Test Name: body temperature; Result Unstructured Data: Test Result:39.2 Centigrade; Comments: without pathological findings
CDC 'Split Type': DEPFIZER INC202101038574

Write-up: Myocardial infarction with occlusion of the circumflex branch, possibly stress-related; Pyrexia/38.7 - 39.2 centigrade; This is a spontaneous report from a non-contactable physician downloaded from the regulatory authority, company number DE-PEI-202100161682. An 89-years-old male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 13Jan2021 at age of 89 years old (Batch/Lot Number: Unknown) as dose number unknown, single for covid-19 immunisation. Medical history included lung inflammation (pneumonia) and swallowing impaired (swallowing disorder), both from unknown date and unknown if it was ongoing. The patient''s concomitant medications were not reported. On 19Jan2021 the patient experienced Infarct myocardial. On 17Jan2021 the patient experienced pyrexia. The patient underwent lab tests and procedures which included body temperature: 38.7 - 39.2 centigrade on 17Jan2021 without pathological findings. Patient was died on 19Jan2021.An autopsy was performed that revealed cause of death: Myocardial infarction with occlusion of the circumflex branch, possibly stress-related. The outcome of Infarct myocardial was fatal and the outcome of pyrexia was unknown.The causality assessment from regulatory authority was D. Unclassifiable. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Myocardial infarction; Autopsy-determined Cause(s) of Death: Myocardial infarction

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