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This is VAERS ID 1328852

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1328852
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-04-11
Onset:2021-05-03
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET9096 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Echocardiogram, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Cardiac ultrasound; Result Unstructured Data: Test Result:Unknown results
CDC 'Split Type': NLPFIZER INC2021539480

Write-up: Cardiac arrest; Myocardial infarction; This is a spontaneous report from a contactable consumer downloaded from the Regulatory Authority-WEB NL-LRB-00534918, received from Regulatory Authority. A 74-year-old male patient received first dose of bnt162b2 (COMIRNATY), via an unspecified route of administration on 11Apr2021 (Batch/Lot Number: ET9096) as single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. Patient didn''t have COVID-19 infection previous. The patient experienced cardiac arrest on 03May2021, Myocardial infarction (Heart attack) followed by cardiac arrest. Cardiac ultrasound in emergency room hospital. Both events treated with Reanimatie. The outcome of cardiac arrest and heart attack was fatal. Patient died on 03May2021. It was unknown if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Myocardial infarction; Cardiac arrest

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