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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1338179

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Case Details

VAERS ID: 1338179 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-27
Onset:2021-01-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9788 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Apnoea, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-03
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MIRTAZAPINE; ASTECON; PANADOL FORTE; MATRIFEN; VISCOTEARS; FURESIS; KALCIPOS-D; BISOPROLOL FUMARATE; PEGORION; KETIPINOR; VENTOLINE; ELIQUIS; SERETIDE DISKUS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease (G30.1 Late-onset); Asthma, unspecified (J45.9); Atherosclerotic cardiovascular disease (I25.1); Constipation; Depression; Dry eye; Heart disease, unspecified (a pre-existing heart disease); Hypercholesterolemia (E78.0); Ischaemia (I25.9); Oedema peripheral; Osteoporosis; Pain
Allergies:
Diagnostic Lab Data:
CDC Split Type: FIPFIZER INC2021553658

Write-up: Apnoea; Dyspnoea; This is a spontaneous report from a contactable nurse, from the regulatory authority, downloaded from the regulatory authority-WEB. The regulatory authority report number is FI-FIMEA-20212456. An 86-year-old female patient received the first dose of BNT162B2 (COMIRNATY, lot number: EK9788) via intramuscular on 27Jan2021 (unknown age at time of vaccination), at single dose, for COVID-19 immunization. The patient''s medical history included (G30.1 Late-onset) Alzheimer''s disease, (I25.1) atherosclerotic essential RR disease, (J45.9) unspecified asthma, (E78.0) hypercholesterolemia, (I25.9) unspecified ischaemia, a pre-existing heart disease, depression, pain, dry eye, oedema peripheral, osteoporosis, and constipation. Concomitant medications included mirtazapine taken for depression; montelukast sodium (ASTECON) taken for asthma; paracetamol (PANADOL FORTE); fentanyl (MATRIFEN) taken for pain; carbomer (VISCOTEARS) taken for dry eye; furosemide (FURESIS) taken for oedema peripheral; calcium carbonate/colecalciferol (KALCIPOS-D) taken for osteoporosis; bisoprolol fumarate; macrogol 4000 (PEGORION) taken for constipation; quetiapine fumarate (KETIPINOR); salbutamol (VENTOLINE) taken for asthma; apixaban (ELIQUIS); fluticasone propionate/salmeterol xinafoate (SERETIDE DISKUS) taken for asthma. The patient experienced apnoea and dyspnoea on 29Jan2021 (2 days after vaccination). 07May2021, nurse reported: "The patient was in a long-term care home for Alzheimer''s disease. Two days after receiving the vaccine, shortness of breath while resting and shortness of breath started. The patient died on 03Feb2021. I made this announcement together with other close relatives, based on information from the place of care." The outcome of the events apnoea and dyspnoea was fatal. It was unknown whether an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Apnoea; Dyspnoea


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