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This is VAERS ID 1339143

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First Appeared on 7/9/2021

VAERS ID: 1339143
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-27
Onset:2021-04-15
Submitted:0000-00-00
Entered:2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET7205 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Circulatory collapse, Drug ineffective, Dyspnoea, Loss of consciousness, Pulmonary embolism, Respiratory failure, Syncope, Scan, SARS-CoV-2 test, COVID-19 pneumonia, SARS-CoV-2 antibody test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-26
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: CO-RENITEC; THEOSPIREX [THEOPHYLLINE]; MERCKFORMIN; MILURIT; QUAMATEL; GLICLADA; ASA PROTECT PHARMAVIT; LYRICA; TRAJENTA; ELONTRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthrosis; Asthma; Cerebrovascular disorder; Diabetes mellitus; Hypertension; Obesity; Psychiatric decompensation
Allergies:
Diagnostic Lab Data: Test Date: 20210415; Test Name: COVID-19 with a rapid test; Test Result: Negative ; Test Date: 20210416; Test Name: PCR tests; Test Result: Positive ; Test Date: 20210423; Test Name: PCR tests; Test Result: Positive ; Test Date: 20210415; Test Name: scan; Result Unstructured Data: Test Result:COVID-19 pneumonia; Comments: confirmed COVID-19 pneumonia and pulmonary embolism
CDC 'Split Type': HUPFIZER INC2021559800

Write-up: COVID-19 pneumonia; COVID-19 pneumonia; collapse; loss of consciousness; dyspnea; cardiovascular failure; respiratory failure; asystole; pulmonary embolism; This is a spontaneous report from a contactable other hcp downloaded from the regulatory authority; regulatory authority number HU-OGYI-286621. A 63-years-old female patient received the first dose of BNT162B2(COMIRNATY, lot number/ batch number ET7205) Intramuscular on 27-MAR-2021 at 0.3 ml single to COVID-19 immunisation. Medical history includes psychiatric decompensation, Asthma, hypertension, obesity, diabetes mellitus, cerebrovascular disorder and arthrosis. Concomitant products are enalapril maleate, hydrochlorothiazide(CO-RENITEC), theophylline(THEOSPIREX, 300 mg), metformin hydrochloride(MERCKFORMIN, 1000 mg), allopurinol(MILURIT, 300 mg), famotidine(QUAMATEL, 40 mg), gliclazide(GLICLADA, 30 mg), acetylsalicylic acid(ASA PROTECT PHARMAVIT), pregabalin(LYRICA, 150 mg) , linagliptin(TRAJENTA, 5mg), bupropion hydrochloride (ELONTRIL, 30 mg). On 15Apr2021 the patient was taken to the hospital due to collapse, loss of consciousness and dyspnea. She was tested negative to COVID-19 with a rapid test but scans confirmed COVID-19 pneumonia and pulmonary embolism. PCR tests on 16Apr2021 and 23Apr2021 also confirmed COVID-19 infection. On 26Apr2021 the patients condition deteriorated, she experienced asystole, cardiovascular and respiratory failure, resuscitation was unsuccessful. The patient died due to asystole, pulmonary, Respiratory failure and cardiovascular failure caused by the infection 30 days after vaccination. The patient was hospitalized due to events COVID-19 pneumonia, collapse, loss of consciousness and dyspnea on 15Apr2021. The events asystole, pulmonary embolism, Respiratory failure and cardiovascular failure were assessed as hospitalization prolonged. The patient died on 26-APR-2021. It''s unknown if an autopsy was performed. The cause of death was asystole, pulmonary, Respiratory failure and cardiovascular failure. The patient underwent lab tests and procedures, which included COVID-19 with a rapid test on 15-APR-2021: Negative; scan on 15-APR-2021: confirmed COVID-19 pneumonia and pulmonary embolism; PCR tests on 16Apr2021 and 23Apr2021: Positive also confirmed COVID-19 infection. The outcome of the events asystole, pulmonary embolism, Respiratory failure , cardiovascular failure, COVID-19 pneumonia, Drug ineffective was Fatal, the others was unknown. Sender Comment: COVID-19 pneumonia was detected 19 days after vaccination with COMIRNATY. Immunity does not develop within 19 days after the first dose. The patient died due to asystole, pulmonary and cardiovascular failure caused by the infection 30 days after vaccination. The causal relationship between the vaccine and the event is unlikely. The case is considered serious due to fatal outcome. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: Based on the information currently available, there was not a reasonable possibility that the events "COVID-19 pneumonia, pulmonary embolism, cardiovascular failure, respiratory failure, asystole" were related to BNT162B2. The patient only received single dosage BNT162B2 and was not well protected for the occurrence of COVID-19 pneumonia. ; Reported Cause(s) of Death: asystole; Respiratory failure; cardiovascular failure; pulmonary; pulmonary; pulmonary embolism

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