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This is VAERS ID 1339160

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1339160
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-18
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0725 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Circulatory collapse

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-09
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: Bladder cancer; Haematuria; Hypertension; Metastatic colon cancer; Psychiatric disorder NOS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HUPFIZER INC2021560088

Write-up: cardiovascular failure; This is a spontaneous report from a contactable physician downloaded from the regulatory authority, number HU-OGYI-291221. This spontaneous, serious case was reported on 27Apr2021 by a physician and concerns the occurrence of cardiovascular failure resulting in death after COMIRNATY injection for active immunization to prevent COVID-19. On 18Feb2021 the 77-year-old male patient received COMIRNATY concentrate for dispersion for injection (one dose 0.3 ml, contains tozinameran (COVID-19 mRNA Vaccine embedded in lipid nanoparticles), batch number: EL0725, expiry date: unknown, MAH: BioNTech Manufacturing GmbH/Pfizer) intramuscularly to prevent COVID-19. He received the first Comirnaty vaccine (one dose 0.3 ml, contains tozinameran (COVID-19 mRNA Vaccine embedded in lipid nanoparticles), batch number: EJ6134, expiry date: unknown, MAH: BioNTech Manufacturing GmbH/Pfizer) intramuscularly on 28JAN2021. On 09Mar2021 the patient died from cardiovascular failure caused by the patient''s underlying hematuria, bladder cancer and metastatic colon cancer. Medical history included hematuria, metastatic colon cancer, bladder cancer, hypertension and psychiatric disorder not otherwise specified, all from an unspecified date and unknown if ongoing. Concomitant drugs are not reported. Further information is not expected. It was unknown if autopsy was performed. Sender''s comment: The patient died due to cardiovascular failure 19 days after the second dose of COMIRNATY caused by the patient''s underlying hematuria, bladder cancer and metastatic colon cancer. The events and the vaccination are not related. 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, the Company concurs with the reporter that there is not a reasonable possibility of an association between the suspect medication and the event cardiovascular failure, due most likely to underlying medical conditions.; Reported Cause(s) of Death: cardiovascular failure

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