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This is VAERS ID 1328850

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1328850
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-05-06
Onset:2021-05-06
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET6956 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Pulmonary embolism, Cardiac death, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-06
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: Medical History/Concurrent Conditions: Dementia (already vulnerable with a declining of his health due to dementia and a possible respiratory infection (COVID-19 negative).); Respiratory infection (Patient was already vulnerable with a declining of his health due to dementia and a possible respiratory infection (COVID-19 negative).)
Allergies:
Diagnostic Lab Data: Test Name: covid negative; Test Result: Negative
CDC 'Split Type': NLPFIZER INC2021539546

Write-up: Vulnerable patient, deterioration in dementia in DD respiratory infection, covid negative/Cause of death was either acute cardiac death or lung embolism; Vulnerable patient, deterioration in dementia in DD respiratory infection, covid negative/Cause of death was either acute cardiac death or lung embolism; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number NL-LRB-00533140. A 75-year-old male patient received second dose of bnt162b2 (COMIRNATY), on 06May2021 (Lot Number: ET6956) at 2nd dose , single for covid-19 immunisation. Medical history included the patient was already vulnerable with a declining of his health due to dementia and a possible respiratory infection (COVID-19 negative). The patient previously received first dose of bnt162b2 (COMIRNATY) on 06Apr2021 for covid-19 immunisation. Had no complaints after 1st vaccination. The patient''s concomitant medications were not reported. Vulnerable patient, deterioration in dementia in DD (differential diagnosis) respiratory infection, covid negative. The patient experienced sudden death (death) following administration of covid-19 vaccine pfizer injectable solution for covid 19 immunisation. The outcome of sudden death is fatal. Patient had no complaints or side effects on the day of vaccination: no fever, patient was eating and drinking. Patient died suddenly 7 hours after vaccination. Cause of death was either acute cardiac death or lung embolism. Day of vaccination free of complaints, no temp, just sat up at the table, ate and drank well. No contraindication to vaccination. After representative consultation, vaccinated. Patient was vulnerable, the physician doubt whether vaccination contributed to the worsening condition. No Previous COVID-19 infection. The lab data included covid negative. The patient died on 06May2021. It was not reported if an autopsy was performed. Reporter Comment: BioNTech / Pfizer vaccine (Comirnaty) Past drug therapy BioNTech / Pfizer vaccine (Comirnaty): yes ADRs: no Date: 06Apr2021 Vulnerable patient, deterioration in dementia in DD respiratory infection, covid negative. Additional information ADR: Day of vaccination free of complaints, no temp, just sat up at the table, ate and drank well. No contraindication to vaccination. After representative consultation, vaccinated. Had no complaints after 1st vaccination. Patient was vulnerable, I doubt whether vaccination contributed to the worsening condition. Iom family decided to report anyway. COVID-19 Previous COVID-19 infection: No. No follow-up attempts possible. No further information expected.; Reporter''s Comments: Patient was vulnerable, I doubt whether vaccination contributed to the worsening condition. Family decided to report anyway.; Reported Cause(s) of Death: DD (differential diagnosis) acute cardiac death DD pulmonary embolism; DD (differential diagnosis) acute cardiac death DD pulmonary embolism

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