National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 1769109

Government Disclaimer on use of this data



Case Details

VAERS ID: 1769109 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-05
Onset:2021-07-15
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Ascites, Condition aggravated, Hepatic neoplasm
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Liver tumours of unspecified malignancy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Liver tumour
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC202101291836

Write-up: liver tumour; Condition worsened; Ascites; This is a spontaneous report from a non-contactable physician downloaded from the regulatory authority case identification number: DE-DCGMA-21192052, Safety Report Unique Identifier DE-PEI-202100192193. An 81-year-old male patient received bnt162b2 (COMIRNATY), first dose, via an unspecified route of administration on 05May2021 at the age of 81 years old, as single dose for covid-19 immunisation. Medical history included previously inconspicuous liver tumour. There were no concomitant medications. The patient experienced liver tumour on 15Jul2021, condition worsened on 15Jul2021, ascites on 15Jul2021. The patient died on an unspecified date. It was not reported if an autopsy was performed. This report is serious - death, life threatening. Source of assessment: PEI. Result of Assessment was unclassifiable. Reporter''s comments: ADR: Comirnaty first vaccination, followed by development of fulminant course of a previously inconspicuous liver tumour with ascites, rapid physical deterioration until death. No follow-up attempts are possible. No further information is expected. Information on batch/lot number cannot be obtained.; Reporter''s Comments: ADR: Comirnaty first vaccination, followed by development of fulminant course of a previously inconspicuous liver tumour with ascites, rapid physical deterioration until death.; Reported Cause(s) of Death: Ascites; Condition aggravated; Hepatic neoplasm


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1769109


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166