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This is VAERS ID 1347944

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1347944
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021571448

Write-up: cardiac disorder; This is a spontaneous report based on information received by Pfizer from Biontech [manufacturer control number: 55711], license party for COMIRNATY. This is a spontaneous report from a contactable other healthcare professional (HCP). A male patient of an unspecified age received first dose of BNT162B2 (COMIRNATY) via unspecified route single dose for COVID-19 immunisation on unspecified date. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced cardiac disorder on an unspecified date. The patient died on an unspecified date. It was reported the patient died after 1. dose (not vaccine related, he had cardiac problems). It was unknown if an autopsy was performed. Outcome of the event was fatal. Lot/batch number has been requested.; Sender''s Comments: Based on the current available information, the event cardiac disorder is most likely related to an intercurrent or underlying condition which is not related to the suspected drug. The case will be reassessed if additional information becomes available.; Reported Cause(s) of Death: cardiac disorder

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