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

This is VAERS ID 1338194

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Case Details

VAERS ID: 1338194 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-19
Onset:2021-05-06
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW2246 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram, Blood gases, Blood pressure measurement, Blood test, Body temperature, Coma scale, Echocardiogram, Fraction of inspired oxygen, Glomerular filtration rate, Heart rate, Ischaemic stroke, Neurological examination, Oxygen saturation, Platelet count, Prothrombin time, Pulmonary embolism, Respiratory rate, Visual analogue scale, White blood cell count
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESOMEPRAZOLE; DILTIAZEM; BISOPROLOL; HYDROCHLOROTHIAZIDE; RAMIPRIL; METFORMIN; TRAMADOL; PARACETAMOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cognitive disorder; Hypertension arterial; Iron deficiency anaemia (Regenerative iron deficiency anaemia); Reflux esophagitis; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210506; Test Name: activated partial thromboplastin time; Result Unstructured Data: Test Result:0.8; Test Date: 20210506; Test Name: computed tomography angiography; Result Unstructured Data: Test Result:pulmonary embolism; Comments: multiple endovascular lacunar images compatible with right middle and lower lobar pulmonary embolism.; Test Date: 20210507; Test Name: computed tomography angiography; Result Unstructured Data: Test Result:ischemic stroke; Comments: large right parietal-occipital hypodensity indicating an ischemic stroke. No cerebral haemorrhage. No mass effect or parenchymal expansive process. Ventricular system, cortical sulci and basal cisterns are unremarkable. Vasculodegenerative leukopathy.; Test Date: 20210506; Test Name: gazometry; Result Unstructured Data: Test Result:hypoxia-hypocapnia; Comments: suggesting a pulmonary embolism, although the calves are supple and not painful; Test Date: 20210507; Test Name: gazometry; Result Unstructured Data: Test Result:acidosis; Comments: catastrophic with significant acidosis.; Test Date: 20210506; Test Name: blood pressure; Result Unstructured Data: Test Result:133/77 mmHg; Test Date: 20210507; Test Name: blood pressure; Result Unstructured Data: Test Result:60/40 mmHg; Test Date: 20210506; Test Name: blood panel; Result Unstructured Data: Test Result:anaemia; Comments: probably related to the oesophageal pathology; Test Date: 20210506; Test Name: body temperature; Result Unstructured Data: Test Result:35,7 Centigrade; Test Date: 20210507; Test Name: body temperature; Result Unstructured Data: Test Result:35,7 Centigrade; Test Date: 20210506; Test Name: Glasgow Coma Scale; Result Unstructured Data: Test Result:15; Comments: 15 despite spatial-temporal disorientation; Test Date: 20210507; Test Name: Glasgow Coma Scale; Result Unstructured Data: Test Result:3; Test Date: 20210507; Test Name: cardiac echocardiogram; Result Unstructured Data: Test Result:no right or left myocardial failure; Test Date: 20210507; Test Name: fio2; Test Result: 84 %; Test Date: 20210506; Test Name: mdrd gfr; Test Result: 56 mL; Comments: moderate renal insufficiency; Test Date: 20210506; Test Name: heart rate; Result Unstructured Data: Test Result:128; Comments: /minute; Test Date: 20210506; Test Name: heart rate; Result Unstructured Data: Test Result:90; Comments: /minute; Test Date: 20210507; Test Name: heart rate; Result Unstructured Data: Test Result:94; Test Date: 20210506; Test Name: neurological examination; Result Unstructured Data: Test Result:no signs of localisation; Test Date: 20210506; Test Name: oxygen saturation; Test Result: 99 %; Comments: saturated oxygen 99% in ambient air; Test Date: 20210507; Test Name: oxygen saturation; Test Result: 85 %; Test Date: 20210507; Test Name: oxygen saturation; Test Result: 80 %; Comments: the respiratory insufficiency worsens at 80% in ambient air; Test Date: 20210506; Test Name: platelets; Result Unstructured Data: Test Result:387 g/l; Comments: normal; Test Date: 20210507; Test Name: platelets; Result Unstructured Data: Test Result:386 g/l; Test Date: 20210506; Test Name: prothrombin time; Test Result: 70 %; Test Date: 20210506; Test Name: respiration rate; Result Unstructured Data: Test Result:28; Comments: 28/minute; Test Date: 20210507; Test Name: respiration rate; Result Unstructured Data: Test Result:28; Comments: /minute; Test Date: 20210507; Test Name: Visual Analogue Scale; Result Unstructured Data: Test Result:15; Test Date: 20210506; Test Name: leukocytes; Result Unstructured Data: Test Result:19.8 g/l
CDC Split Type: FRPFIZER INC2021553629

Write-up: Ischemic stroke; Embolism pulmonary; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-2021052029. A 78-years-old male patient received second dose of bnt162b2 (COMIRNATY), intramuscular, administered in Arm Left on 19Apr2021 (Lot Number: EW2246) as 2nd dose, single for covid-19 immunisation. Medical history included Early cognitive disorders, Type 2 diabetes mellitus, Hypertension arterial, Reflux esophagitis, Regenerative iron deficiency anaemia. No COVID HISTORY. Concomitant medications included esomeprazole, diltiazem, bisoprolol, hydrochlorothiazide, ramipril, metformin, tramadol, paracetamol. The patient previously received first dose of bnt162b2, on 23Mar2021 (Lot Number: ER9470) as 1st dose, single for covid-19 immunisation. 17 days after Dose 2, on 06May2021, the patient was sent to the Emergency Room by their general practitioner due to a change in their general state with dyspnoea, date of onset not provided. The clinical examination was without any significant particularity (35.7?C; 133/77mmHg; Heart rate 128/minute; saturated oxygen 99% in ambient air; respiration rate 28/minute; Glasgow Coma Scale 15 despite spatial-temporal disorientation; Glc cap. 3g/l; symmetrical vesicular murmur with no rattle, neurological examination with no signs of localisation). Heart rate slowed spontaneously to sinus rhythm at 90/minute. The blood panel revealed anaemia (probably related to the oesophageal pathology), hyperleucocytosis (19.8g/l), moderate renal insufficiency (MDRD 56ml/minute) and, above all, hypoxia-hypocapnia, suggesting a pulmonary embolism, although the calves are supple and not painful. The platelets are normal at 387g/l. Prothrombin time 70%, activated partial thromboplastin time 0.8. This hypothesis is confirmed by computed tomography angiography: multiple endovascular lacunar images compatible with right middle and lower lobar pulmonary embolism. The patient is placed on Apixaban, and admitted to hospital. The patient had a slightly agitated night (got up, fell, incoherent remarks). In the afternoon of 07May2021, (Day 18 from Dose 2), while starting an erythrocyte transfusion, the respiratory insufficiency worsens with saturated oxygen at 80% in ambient air, appearance of crepitants at mid-field (Furosemide, high concentration oxygen), increase of cognitive disorders with agitation, no hemodynamic alteration. Platelets on 07May2021: 386g/l. Upon being taken into care around 16:45: 35.7?c; 60/40mmHg ; heart rate 94/minute; saturated o2 85% on FiO2 84% ; Respiratory rate 28/minute; Glasgow Coma Scale 3; Visual Analogue Scale 15; Glc cap. 5.09g/l Conduct: non-invasive ventilation (NIV) with face mask; Noradrenalin; cardiac echocardiogram done: no right or left myocardial failure. Sudden neurological deterioration with Glasgow Coma 3, the appearance of a left mydriasis while an anticoagulant treatment had just been started: a cerebral computed tomography scan is requested. Progression:The gazometry on non-invasive ventilation is catastrophic with significant acidosis. The computed tomography scan showed a large right parietal-occipital hypodensity indicating an ischemic stroke. No cerebral haemorrhage. No mass effect or parenchymal expansive process. Ventricular system, cortical sulci and basal cisterns are unremarkable. Vasculodegenerative leukopathy. Death is recorded at 18:25 at the end of carrying out the computed tomography scan. The declarant concludes a thrombotic storm with severe pulmonary embolism then ischemic stroke despite the prescription since the day before of Apixaban in a hypertensive, type II diabetic man who had received the second injection of Comirnaty vaccine 17 days earlier. Regenerative iron deficiency anaemia which could not be investigated but probably related to oesophageal pathology on hiatus hernia (history of oesophagitis). Moderate renal insufficiency. Coma then asystole leading to death. According to the declaring resucitator, the clinical signs seemed very unusual. He suggested a hypothesis of a paradoxical embolism linked to a permeable oval foramen, but the localisation of the cerebral vascular accident does not favour this hypothesis. Further, the pulmonary embolism was not massive. Awaiting information on a possible blood sample for a thrombophilia test and anti-PF4 antibody level test (but unlikely to have been carried out in this very rapidly unfavourable context). In summary: pulmonary embolism followed by a massive ischemic stroke 17 days after the 2nd dose of COMIRNATY in a 78-year old patient, leading to his death; normal platelets, no dose of anti-PF4 antibodies." The patient died on 07May2021. An autopsy was not performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Embolism pulmonary; Ischemic stroke


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