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This is VAERS ID 1339150

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1339150
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-04
Onset:2021-03-16
Submitted:0000-00-00
Entered:2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET1831 / 1 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Cardiac failure, Chest X-ray, Respiratory failure, Shock, Multiple organ dysfunction syndrome, COVID-19, SARS-CoV-2 test, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
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? No
Previous Vaccinations:
Other Medications: ADEXOR; ELIQUIS
Current Illness: Fatty liver; Gastroesophageal reflux; NIDDM; Obesity
Preexisting Conditions: Medical History/Concurrent Conditions: Choroid neoplasm; Pulmonary embolism
Allergies:
Diagnostic Lab Data: Test Date: 20210316; Test Name: Chest X-ray; Result Unstructured Data: Test Result:COVID-19 pneumonia; Comments: diagnose of COVID-19 pneumonia; Test Date: 20210316; Test Name: SARS-CoV-2 test positive; Test Result: Positive ; Comments: diagnose of COVID-19; Test Name: Body temperature; Result Unstructured Data: Test Result:fever (unknown value)
CDC 'Split Type': HUPFIZER INC2021560200

Write-up: respiratory failure; shock; multiple organ failure; heart failure; COVID-19; COVID-19 pneumonia; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number HU-OGYI-288321. A 72-year-old female patient received first dose of BNT162B2 (COMIRNATY), intramuscular, administered in arm left on 04Mar2021 (Batch/Lot Number: ET1831) as 0.3 mL single dose for COVID-19 immunisation. Medical history included ongoing type 2 diabetes mellitus (NIDDM), pulmonary embolism in 2016, ongoing gastrooesophageal reflux disease, ongoing fatty liver, choroid neoplasm from an unknown date and unknown if ongoing and ongoing obesity. Concomitant medications included trimetazidine hydrochloride (ADEXOR, strength: 80 mg ) at 80 mg once a day and apixaban (ELIQUIS, strength: 2.5 mg) at 2.5 mg twice a day, both taken for an unspecified indication, start and stop date were not reported. On an unspecified date the patient experienced fever and dyspnoea. On 11Mar2021, the patient was hospitalized. On 16Mar2021, the patient''s COVID-19 test was positive. On the same day, chest X-ray showed COVID-19 pneumonia. The patient''s condition worsened with time in the hospital. In the hospital, the patient received medicinal therapy as antibiotics, antiviral therapy, steroids, mucolytic medicines, mucus protective medicines, LMWH and oxygen therapy. The course of the disease was critical, the patient had respiratory failure, shock and multiple organ failure. On 02Apr2021, the patient died. According to the patient''s death certificate, the direct cause of death was heart failure. The primary disease that caused the patient''s death was COVID-19, which escalated to COVID-19 pneumonia and respiratory failure. It was not reported if an autopsy was performed. No follow-up attempts are needed. No further information is expected.; Reported Cause(s) of Death: heart failure; COVID-19 pneumonia; covid-19; respiratory failure; shock; multiple organ failure

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