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This is VAERS ID 871626

History of Changes from the VAERS Wayback Machine

First Appeared on 8/14/2020

VAERS ID: 871626
VAERS Form:2
Age:84.0
Sex:Female
Location:Foreign
Vaccinated:2019-10-30
Onset:2020-03-25
Submitted:0000-00-00
Entered:2020-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (CHIROMAS) / NOVARTIS VACCINES AND DIAGNOSTICS 9153B1A / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-03-28
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: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESSEQIRUS202003587

Write-up: Pneumonia from COVID-19; This is a spontaneous case, reported by pharmacist to Regulatory Authority (regulatory reference number: ES-AEMPS-630523) and initially retrieved on 21-May-2020, concerning a 84-year-old, female patient. The patient''s medical history and concomitant medications were not reported. On 30-Oct-2019, the patient was administered Chiromas (TIV) [influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59; batch number: 9153B1A; dose: 0.5 ml; route of administration: intramuscular; anatomical location and expiry date: not reported] as flu vaccination. On 25-Mar-2020, four months and 25 days after vaccination, the patient developed pneumonia from COVID-19. On 28-Apr-2020, the patient died due to the pneumonia from COVID-19. It was unknown if the autopsy was done. The event of ''COVID-19 pneumonia'' was considered serious due to the criterion of medical significance and fatal outcome. The reporter did not provide causality assessment. This case is linked with the cases: 202003580, 202003581, 202003582, 202003583, 202003584, 202003585 and 202003586 (Regulatory Authority link). Company comment: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine.; Sender''s Comments: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine. ES-AEMPS-630999: ES-AEMPS-630975: ES-AEMPS-630996: ES-AEMPS-630974: ES-AEMPS-630545: ES-AEMPS-630989: ES-AEMPS-630547:; Reported Cause(s) of Death: Pneumonia from COVID-19


Changed on 12/24/2020

VAERS ID: 871626 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Foreign
Vaccinated:2019-10-30
Onset:2020-03-25
Submitted:0000-00-00
Entered:2020-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (CHIROMAS) / NOVARTIS VACCINES AND DIAGNOSTICS 9153B1A / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-03-28
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: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESSEQIRUS202003587

Write-up: Pneumonia from COVID-19; This is a spontaneous case, reported by pharmacist to Regulatory Authority (regulatory reference number: ES-AEMPS-630523) and initially retrieved on 21-May-2020, concerning a 84-year-old, female patient. The patient''s medical history and concomitant medications were not reported. On 30-Oct-2019, the patient was administered Chiromas (TIV) [influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59; batch number: 9153B1A; dose: 0.5 ml; route of administration: intramuscular; anatomical location and expiry date: not reported] as flu vaccination. On 25-Mar-2020, four months and 25 days after vaccination, the patient developed pneumonia from COVID-19. On 28-Apr-2020, the patient died due to the pneumonia from COVID-19. It was unknown if the autopsy was done. The event of ''COVID-19 pneumonia'' was considered serious due to the criterion of medical significance and fatal outcome. The reporter did not provide causality assessment. This case is linked with the cases: 202003580, 202003581, 202003582, 202003583, 202003584, 202003585 and 202003586 (Regulatory Authority link). Company comment: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine.; Sender''s Comments: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine. ES-AEMPS-630999: ES-AEMPS-630975: ES-AEMPS-630996: ES-AEMPS-630974: ES-AEMPS-630545: ES-AEMPS-630989: ES-AEMPS-630547:; Reported Cause(s) of Death: Pneumonia from COVID-19


Changed on 12/30/2020

VAERS ID: 871626 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Foreign
Vaccinated:2019-10-30
Onset:2020-03-25
Submitted:0000-00-00
Entered:2020-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (CHIROMAS) / NOVARTIS VACCINES AND DIAGNOSTICS 9153B1A / UNK - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Death, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-03-28
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: Comments: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESSEQIRUS202003587

Write-up: Pneumonia from COVID-19; This is a spontaneous case, reported by pharmacist to Regulatory Authority (regulatory reference number: ES-AEMPS-630523) and initially retrieved on 21-May-2020, concerning a 84-year-old, female patient. The patient''s medical history and concomitant medications were not reported. On 30-Oct-2019, the patient was administered Chiromas (TIV) [influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59; batch number: 9153B1A; dose: 0.5 ml; route of administration: intramuscular; anatomical location and expiry date: not reported] as flu vaccination. On 25-Mar-2020, four months and 25 days after vaccination, the patient developed pneumonia from COVID-19. On 28-Apr-2020, the patient died due to the pneumonia from COVID-19. It was unknown if the autopsy was done. The event of ''COVID-19 pneumonia'' was considered serious due to the criterion of medical significance and fatal outcome. The reporter did not provide causality assessment. This case is linked with the cases: 202003580, 202003581, 202003582, 202003583, 202003584, 202003585 and 202003586 (Regulatory Authority link). Company comment: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine.; Sender''s Comments: A 84-year-old, female patient experienced COVID-19 pneumonia, four months and 25 days after administration of Chiromas (TIV) influenza vaccine. Reportedly, the patient died due to pneumonia from COVID-19. It was unknown if autopsy was performed. Considering infectious aetiology of the event and biological implausibility, the causality is assessed as not related to the suspect vaccine. ES-AEMPS-630999: ES-AEMPS-630975: ES-AEMPS-630996: ES-AEMPS-630974: ES-AEMPS-630545: ES-AEMPS-630989: ES-AEMPS-630547:; Reported Cause(s) of Death: Pneumonia from COVID-19

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