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Write-up: Extensive cerebral haemorrhage/Hypertensive cerebral haemorrhage; Brain herniation; Consciousness disturbed; This is a spontaneous report from a contactable pharmacist. This is a report received from the Regulatory Authority (RA). Regulatory authority report number is v21106552. A 95-year-old female patient received the first dose of the bnt162b2 (COMIRNATY; Lot Number: EW4811; Expiration Date: 31Jul2021), via an unspecified route of administration on 10May2021 at 14:30 at a single dose for covid-19 immunisation. Medical history included hepatic disease. The patient''s concomitant medications were not reported. On 12May2021 at 19:00, the patient experienced extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed, which required emergency room visit and hospitalization from 12May2021 to 13May2021. The clinical course was as follows: on 10May2021 around 14:30 (the day of vaccination), the patient received the first dose of BNT162b2. On 12May2021 at 19:00 (2 days after the vaccination), the patient experienced consciousness disturbed. On 12May2021 at 22:00 (2 days after the vaccination), the patient was groaning on the floor in her room and was unresponsive to calls; an ambulance was called and transported the patient to the reporting hospital. On 12May2021 (2 days after the vaccination), the patient was admitted to the hospital. Extensive cerebral haemorrhage mainly manifesting from the left thalamus over the left putamen was noted with a condition of brain herniation. The patient would only be attended on her deathbed as it was difficult to save her. On 13May2021 (3 days after the vaccination), the patient died and was discharged. The patient underwent lab tests and procedures which included body temperature: 36.8 degrees Centigrade on 10May2021 before vaccination. Therapeutic measures were taken as a result of extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed. The clinical outcome of the event was fatal. The patient died on 13May2021 due to extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed. It was not reported if an autopsy was performed. The reporting physician classified the events as serious (hospitalization) and assessed the causality between the events and BNT162b2 as unassessable. Other possible cause of the events such as any other diseases was hypertensive cerebral haemorrhage. No follow-up attempts needed. No further information expected, batch number/ lot number cannot be obtained.; Reported Cause(s) of Death: Consciousness disturbed; Brain herniation; Extensive cerebral haemorrhage/Hypertensive cerebral haemorrhage
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