National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

From the 1/7/2022 release of VAERS data:

This is VAERS ID 1339163

Government Disclaimer on use of this data

Case Details

VAERS ID: 1339163 (history)  
Form: Version 2.0  
Sex: Male  
Location: Foreign  
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Bronchial neoplasm, Death, Lung neoplasm, Neoplasm progression
SMQs:, Malignancy related conditions (narrow), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bronchial neoplasm; COPD; Lung neoplasm
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: HUPFIZER INC2021560197

Write-up: Bronchial neoplasm progresion; Bronchial neoplasm progresion; Lung neoplasm progression; Lung neoplasm progression; death; This is a spontaneous report from a contactable other healthcare professional downloaded from the Regulatory Authority. A 63-years-old male patient received bnt162b2 (COMIRNATY), dose 2 intramuscular, administered in Arm Left on 20Feb2021 (Batch/Lot Number: EP2163) as 0.3 mL, single for covid-19 immunisation . Medical history included ongoing chronic obstructive pulmonary disease , ongoing lung neoplasm , ongoing bronchial neoplasm. The patient''s concomitant medications were not reported. On 30Jan2021, the patient received the first dose. Comirnaty The patient died on 22Feb2021. According to the patient death certificate, direct cause of death were respiratory and circulatory failure, indirect causes was lung and bronchial neoplasm. According to the physician, the patient death is related to his underlying diseases. The autopsy was not performed. Sender Comment: According to the SmPC of Comirnaty concentrate for dispersion for injection, death is not expected. TTO (to take out) is 2 days. Dechallenge and rechallenge were not applicable. The causal relationship between the suspected drug and the events is considered unlikely. The case is considered serious due to fatal outcome. No further information is expected.; Reported Cause(s) of Death: respiratory and circulatory failure - direct cause according to the patient death certificate; respiratory and circulatory failure - direct cause according to the patient death certificate; lung and bronchial neoplasm - indirect cause according to th

New Search

Link To This Search Result:

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