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This is VAERS ID 960201

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 960201
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-08
Onset:2021-01-10
Submitted:0000-00-00
Entered:2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0141 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-10
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: ; ; ASPIRIN [ACETYLSALICYLIC ACID]; ; ;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cognitive impairment (mild); CVA; Myocardial infarction; Comments: Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021040949

Write-up: Death; This is a spontaneous report received from a contactable physician by Pfizer from the Medicines and Healthcare products Regulatory Agency (MHRA). The regulatory authority report number is GB-MHRA-WEBCOVID-202101141345001560. An 84-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: EL0141, via an unspecified route of administration on 08Jan2021 at a single dose for COVID-19 immunization. Medical history included cerebrovascular accident from 2018 to an unknown date, myocardial infarction from 2018 to an unknown date and cognitive disorder (mild). Concomitant medication included atorvastatin (MANUFACTURER UNKNOWN), bisoprolol (MANUFACTURER UNKNOWN), acetylsalicylic acid (ASPIRIN), tamsulosin (MANUFACTURER UNKNOWN), clopidogrel (MANUFACTURER UNKNOWN) and esomeprazole (MANUFACTURER UNKNOWN). The patient has not had symptoms associated with COVID-19 and is not enrolled in a clinical trial. On 10Jan2021, the patient experienced death. It was reported that the patient was found dead at home 2 days after vaccination. It was discussed by the coroner that they felt it was likely due to myocardial infarction (MI) and likely unrelated to vaccination. The patient died on 10Jan2021. The cause of death was myocardial infarction. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Myocardial infarction

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