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

This is VAERS ID 1342840

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Case Details

VAERS ID: 1342840 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX3510 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Cardiac arrest, Cardiac procedure complication, Cough, Dyspnoea, Malaise, Myocardial infarction, Nausea, Vaccination site pain
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021561172

Write-up: Nausea, shortness of breath, cough, cardiac arrest with fatal consequences; Myocardial infarction due to a suddenly occluded blood vessel in the coronary artery; Myocardial infarction due to a suddenly occluded blood vessel in the coronary artery; Nausea, shortness of breath, cough, cardiac arrest with fatal consequences; Nausea, shortness of breath, cough, cardiac arrest with fatal consequences; Nausea, shortness of breath, cough, cardiac arrest with fatal consequences; Nausea, shortness of breath, cough, cardiac arrest with fatal consequences; Injection site pain; unwell; This is a spontaneous report from a non-contactable consumer downloaded from a regulatory authority-WEB DE-PEI-CADR2021065554, Safety Report Unique Identifier DE-PEI-202100058213. A 56-year-old male patient received first dose of bnt162b2 (COMIRNATY, reported as mRNA TOZINAMERAN, solution for injection, strength: 0.3mL, Batch/Lot Number: EX3510), via an unspecified route of administration on 20Apr2021 (at the age of 56-year-old) at single dose for COVID-19 immunisation. The patient''s medical history and concurrent conditions included COVID-19 from 2020 to an unknown date, not ongoing. The patient''s concomitant medications were not reported. The patient experienced myocardial infarction due to a suddenly occluded blood vessel in the coronary artery, nausea, shortness of breath, cough, cardiac arrest with fatal consequences, all on 27Apr2021; injection site pain and unwell on 20Apr2021. It was reported that on 27Apr2021 the patient experienced Arrhythmia. On 20Apr2021 the patient experienced Malaise, Injection site pain. On 27Apr2021 the patient experienced Infarct myocardial, Nausea, Dyspnoea, Coughing, Arrest cardiac. The outcome of events ''myocardial infarction due to a suddenly occluded blood vessel in the coronary artery'' and cardiac arrest was fatal, outcome of injection site pain was recovered on 22Apr2021, outcome of the other events was not recovered. The patient died on 27Apr2021. An autopsy was not performed. This report is serious - death, hospitalization. A regulatory authority assessed the causal relationship between bnt162b2 (COMIRNATY) and all the reported events as D. Unclassifiable. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: cardiac arrest; a suddenly occluded blood vessel in the coronary artery; Infarct myocardial


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