National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

This is VAERS ID 1338202

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1338202
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-18
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: Aortic valve disease mixed; Colon cancer; Nephrectomy; Renal carcinoma (renal carcinoma in 2002 with nephrectomy)
Diagnostic Lab Data:
CDC 'Split Type': FRPFIZER INC2021553644

Write-up: Sudden death; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB. The regulatory authority report number is [FR-AFSSAPS-BX20214353] and Safety Report Unique Identifier [FR-AFSSAPS-2021052758]. An 85-year-old male patient received BNT162B2 (COMIRNATY) (Batch/Lot Number: EW2246) via intramuscular, administered in arm left on 09Apr2021 as 2nd dose, single for covid-19 immunisation. Medical history included moderate aortic valve disease; renal carcinoma in 2002 with nephrectomy; colon cancer in 2017. The patient''s concomitant medications were not reported. Patient previously received first dose of BNT162B2 for covid-19 immunisation. On Day 9 of Dose 2 (18Apr2021), patient was found dead in the shower, although he was asymptomatic a few minutes before. The sudden death without triggering factor or cause found. Patient did not have Covid-19; he had not been tested. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The reported cause of death was sudden death without triggering factor. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: sudden death without triggering factor

New Search

Link To This Search Result:

Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166