National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

This is VAERS ID 1338262

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1338262
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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
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

New Search

Link To This Search Result:

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