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This is VAERS ID 890336

History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 890336
VAERS Form:2
Age:75.0
Sex:Male
Location:Foreign
Vaccinated:2019-11-26
Onset:2020-07-02
Submitted:0000-00-00
Entered:2020-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (CHIROMAS) / NOVARTIS VACCINES AND DIAGNOSTICS 9153A1A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-07-03
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': ESSEQIRUS202005216

Write-up: Pneumonia from COVID-19; This spontaneous case from Spain was retrieved on 15-Oct-2020 from EudraVigilance (regulatory reference number: ES-AEMPS-679932), reported by a pharmacist and concerned a 75-year-old, male patient. The patient''s medical history and concomitant medications were not reported. On 26-Nov-2019, the patient was vaccinated with Chiromas (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59; dose: single dose, route of administration: intramuscular and anatomical location: not reported] as flu vaccination. The batch number reported was 9153A1A. On 02-Jul-2020, seven months and six days after receiving Chiromas (TIV), the patient developed pneumonia from COVID-19. On 03-Jul-2020, the patient died due to the pneumonia from COVID-19. It was unknown if the autopsy was done. The reporter did not provide causality assessment. The event of ''COVID-19 pneumonia'' was considered serious due to the criterion of medical significance and fatal outcome by a Physician within Seqirus'' Pharmacovigilance and Risk Management Department. Company comment: A 75-year-old, male patient was administered the suspect product, Chiromas (TIV). The patient developed COVID-19 infection, seven months and six days after vaccination. Reportedly, the patient died due to COVID-19 infection. It was not reported whether autopsy was performed. The patient''s medical history and concomitant medications were not reported. Considering biological implausibility, causal role of the suspect vaccine is assessed as not related.; Sender''s Comments: A 75-year-old, male patient was administered the suspect product, Chiromas (TIV). The patient developed COVID-19 infection, seven months and six days after vaccination. Reportedly, the patient died due to COVID-19 infection. It was not reported whether autopsy was performed. The patient''s medical history and concomitant medications were not reported. Considering biological implausibility, causal role of the suspect vaccine is assessed as not related. ES-AEMPS-630523:; Reported Cause(s) of Death: Pneumonia from COVID-19


Changed on 5/7/2021

VAERS ID: 890336 Before After
VAERS Form:2
Age:75.0
Sex:Male
Location:Foreign
Vaccinated:2019-11-26
Onset:2020-07-02
Submitted:0000-00-00
Entered:2020-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (CHIROMAS) / NOVARTIS VACCINES AND DIAGNOSTICS 9153A1A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-07-03
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': ESSEQIRUS202005216

Write-up: Pneumonia from COVID-19; This spontaneous case from Spain was retrieved on 15-Oct-2020 from EudraVigilance (regulatory reference number: ES-AEMPS-679932), reported by a pharmacist and concerned a 75-year-old, male patient. The patient''s medical history and concomitant medications were not reported. On 26-Nov-2019, the patient was vaccinated with Chiromas (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59; dose: single dose, route of administration: intramuscular and anatomical location: not reported] as flu vaccination. The batch number reported was 9153A1A. On 02-Jul-2020, seven months and six days after receiving Chiromas (TIV), the patient developed pneumonia from COVID-19. On 03-Jul-2020, the patient died due to the pneumonia from COVID-19. It was unknown if the autopsy was done. The reporter did not provide causality assessment. The event of ''COVID-19 pneumonia'' was considered serious due to the criterion of medical significance and fatal outcome by a Physician within Seqirus'' Pharmacovigilance and Risk Management Department. Company comment: A 75-year-old, male patient was administered the suspect product, Chiromas (TIV). The patient developed COVID-19 infection, seven months and six days after vaccination. Reportedly, the patient died due to COVID-19 infection. It was not reported whether autopsy was performed. The patient''s medical history and concomitant medications were not reported. Considering biological implausibility, causal role of the suspect vaccine is assessed as not related.; Sender''s Comments: A 75-year-old, male patient was administered the suspect product, Chiromas (TIV). The patient developed COVID-19 infection, seven months and six days after vaccination. Reportedly, the patient died due to COVID-19 infection. It was not reported whether autopsy was performed. The patient''s medical history and concomitant medications were not reported. Considering biological implausibility, causal role of the suspect vaccine is assessed as not related. ES-AEMPS-630523:; Reported Cause(s) of Death: Pneumonia from COVID-19

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