National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 976492



Case Details

VAERS ID: 976492 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-10
Onset:2021-01-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BNT162B2 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram head, Subarachnoid haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-17
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ACLIDINIUM BROMIDE; VENTOLIN [SALBUTAMOL SULFATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COPD; 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: Test Name: CT head; Result Unstructured Data: Test Result:results not provided
CDC Split Type: GBPFIZER INC2021052072

Write-up: Subarachnoid hemorrhage; This is a spontaneous report from a contactable Physician. This is a report received from the MHRA. Regulatory authority report number GB-MHRA-WEBCOVID-202101191508083250, Safety Report Unique Identifier GB-MHRA-ADR 24615904 An 83-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: BNT162b2, expiry date not reported), via an unspecified route of administration on 10Jan2021 at single dose for COVID-19 immunization. Medical history included chronic obstructive pulmonary disease from an unknown date and unknown if ongoing. Concomitant medication included aclidinium bromide and salbutamol sulfate (VENTOLIN); both for chronic obstructive pulmonary disease. The patient experienced subarachnoid hemorrhage on 14Jan2021. The patient underwent lab tests and procedures which included computerised tomogram head: results not provided on an unspecified date. The patient died on 17Jan2021. It was not reported if an autopsy was performed. The outcome of the event was fatal. No follow-up attempts possible; information regarding batch/lot cannot be obtained; No further information expected.; Reported Cause(s) of Death: Subarachnoid hemorrhage


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=976492

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166