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This is VAERS ID 971356

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 971356
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-07
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Headache, Malaise, Oxygen saturation, Presyncope, Pyrexia, Vaccination complication, Blood pressure measurement

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: SINTROM; DIGOXINA KERN PHARMA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic atrial fibrillation (CONTROLLED ANTICOAGULANT TREATMENT); Fibrillation atrial (CONTROLLED ATRIAL FIBRILLATION)
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:120/70; Test Name: body temperature; Result Unstructured Data: Test Result:37.5 Centigrade; Comments: fever peak of 37.5 Centigrade; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:93-95 %
CDC 'Split Type': ESPFIZER INC2021054355

Write-up: Vaso vagal attack; Fever; Vaccination adverse reaction; General malaise; Headache; This is a spontaneous report from a contactable consumer downloaded from the European Medicines Agency (EMA) EudraVigilance-WEB. The regulatory authority report number is ES-AEMPS-714909. An 85-year-old male patient received BNT162B2 (COMIRNATY), via an unspecified route of administration in the arm on 07Jan2021 as single dose for covid-19 immunization. Medical history included chronic atrial fibrillation from an unknown date reported with controlled anticoagulant treatment and (detailed as controlled atrial fibrillation), from unknown dates. Concomitant medication included acenocoumarol (SINTROM) for chronic atrial fibrillation from 21Jan2016, digoxin (DIGOXINA KERN PHARMA) also for chronic atrial fibrillation from 21Jan2016. The patient experienced the following fatal events: headache on 09Jan2021, fever on 09Jan2021, vaccination adverse reaction on 09Jan2021, general malaise on 09Jan2021, vaso vagal attack on 10Jan2021. The patient underwent lab tests and procedures which included blood pressure: 120/70 and oxygen saturation: 93-95 % on an unspecified date. The patient had not gone through a COVID-19. Details were as follows: On day 9 the male patient started to experience general malaise with mild headache and fever peak of 37.5 Centigrade. In the morning of day 10 the general malaise got worse and the normal values were maintained. The blood pressure was 120/70 and oxygen saturation of 93-95 %. On day 10 he ate breakfast and ate a lot, and after lunch, he had a cardiac arrest, which resulted in a vasovagal attack in which the blood pressure could not be taken nor the pulse be found. 061 Services were called and advanced Cardiopulmonary resuscitation was performed for 30 minutes, with no response, thus 2.30 p.m. death was declared. The patient died on 10Jan2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. Information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Cardiac arrest

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