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

This is VAERS ID 990192



Case Details

VAERS ID: 990192 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-05
Onset:2021-01-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EE8493 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Death, Malaise
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-08
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Obesity; Comments: Staff member received the vaccine as part of the vaccination programme. Health questionnaire highlighted 1 risk factor - obesity No other health contraindications noted in the assessment Unsure if patient has had symptoms associated with COVID-19 Patient has not been tested/or has had an inconclusive test for COVID-19. Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021029248

Write-up: death unexplained; Chest tightness; Chest pain; Generally unwell; This is a spontaneous report received from the Regulatory Agency. Regulatory Authority Report Number: GB-MHRA-WEBCOVID-20210113081829, Safety Report Unique Identifier: GB-MHRA-ADR 24587106. A contactable other healthcare professional reported that a 54-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EE8493, expiration date: unknown), via an unspecified route of administration on 05Jan2021 at a single dose for COVID-19 immunization. Medical history included obesity; health questionnaire highlighted 1 risk factor as obesity. No other health contraindications noted in the assessment. The patient''s concomitant medications were not reported. It was unsure if the patient has had symptoms associated with COVID-19. The patient has not been tested/or has had an inconclusive test for COVID-19. The patient is not enrolled in clinical trial. The staff member received the vaccine on Tuesday (05Jan2021) as part of the vaccination programme, felt generally unwell, returned to work and worked for the rest of the week. On Friday (08Jan2021), the patient reported to the line manager, feeling generally unwell with some mild chest tightness. The patient was advised to attend meeting but refused and was sent home with the guidance to seek medical help if not better. According to a family member, the chest pain increased during the evening, 999 was called but the patient died prior to arrival. Paramedics attempted resuscitation for approximately 45 minutes but were unsuccessful. The patient has not tested positive for COVID-19 since having the vaccine. The patient died on 08Jan2021. The outcome of the rest of the events was unknown. 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: Death unexplained


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