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This is VAERS ID 1338262

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1338262
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-04-03
Onset:2021-04-18
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Drug ineffective, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-04
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: Bone metastases; Hypertension arterial; Type 2 diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210414; Test Name: febrile; Result Unstructured Data: Test Result:38 Centigrade; Test Date: 20210418; Test Name: Sars-cov-2 test; Test Result: Positive
CDC 'Split Type': FRPFIZER INC2021553633

Write-up: drug ineffective; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report from a contactable other hcp downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-RN20211289. A 73-years-old male patient received first dose of bnt162b2 (COMIRNATY), intramuscular on 13Feb2021 (Lot Number: EM0477) as 1st dose, single, second dose intramuscular on 03Apr2021 (Lot Number: EJ6788) as 2nd dose, single, for covid-19 immunisation. Medical history included ongoing Bone metastases, ongoing type 2 diabetes mellitus , ongoing Hypertension arterial , covid-19. The patient''s concomitant medications were not reported. Symptoms included flu syndrome (asthenia and febrile 38C) from 14Apr2021, as well as diarrhoea on 22Apr2021. Patient positive for Covid-19. COVID-19 test on 18Apr2021 was positive. On 04May2021, the patient was dead. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19 confirmed by positive COVID-19 test; drug ineffective

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