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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1339926

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Case Details

VAERS ID: 1339926 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-15
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-17
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Overweight
Allergies:
Diagnostic Lab Data:
CDC Split Type: NOPFIZER INC2021554083

Write-up: EMBOLISM PULMONARY; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB, regulatory authority number NO-NOMAADVRE-FHI-2021-Umwy3p, Safety Report Unique Identifier NO-NOMAADVRE-E2B_00028831. A 57-year-old female patient received bnt162b2 (COMIRNATY), dose 2 intramuscular on 15Apr2021 (Batch/Lot Number: Unknown) as single dose for covid-19 immunisation. Medical history included overweight. The patient''s concomitant medications were not reported. The patient experienced embolism pulmonary on an unspecified date in Apr2021. Pulmonary embolism with fatal outcome is reported one to two days after vaccination. The patient was significantly overweight. Otherwise, there were no known risk factors for pulmonary embolism. The patient was legally autopsied. The patient died of embolism pulmonary on 17Apr2021. An autopsy was performed and results were not provided. Relatedness of drug to reaction/event: Source of assessment - an unlisted regulatory authority. Result of Assessment was Possible. Sender''s comment: Thank you for reporting a suspected side effect after vaccination. If you should have further information related to the incident, this can be sent in response to this message. The information is processed securely, and this dialog is automatically deleted after 4 months. Processing and storage of personal data takes place in accordance with the Health Register Act. Since the vaccine is new, it is subject to special surveillance in order to detect new safety information as quickly as possible. It is especially important that serious and / or unusual side effects are reported. Your message is therefore important to increase knowledge about side effects that have not been discovered in the studies, and is an important contribution to international cooperation to maintain safe vaccination worldwide. Reports after coronary vaccination in the Adverse Reaction Register are processed by the Norwegian Institute of Public Health in collaboration with a regulatory authority. Causality is assessed in accordance with international criteria. We do not currently have the capacity to send individual adverse reaction reports. For updated information and advice on the use of the vaccines and precautions, refer to the Vaccination Guide. Questions about coronary vaccine that cannot be answered by local experts can be directed to PRIVACY. We request that no special categories of personal information (health information) be sent by e-mail. If it is impossible to ask a question without including such information, we recommend calling the vaccine telephone. No follow-up attempts possible. No further information expected. Lot/Batch number cannot be obtained.; Reported Cause(s) of Death: embolism pulmonary


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