Adverse Event Reporting
| VAERS ID | 1388763 |
|---|---|
| Gender | Female |
| Age | 84 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EP9598 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-02-19 |
| Onset | 2021-02-27 |
| Condition | Hospitalized Died |
Symptoms
- SARS-CoV-2 test
- COVID-19
- X-ray
- COVID-19 pneumonia
- Pulmonary congestion
- Cardiac failure
- Acute respiratory distress syndrome
- Vaccination failure
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Coronary heart disease; Type II diabetes mellitus
Other Medications
FUROSEMIDE; MERONEM; CLEXANE; APIDRA
Previous Vaccinations
Allergies
Laboratory Data
Test Date: 20210227; Test Name: COVID-19 PCR test; Test Result: Positive ; Test Date: 20210227; Test Name: x-ray; Result Unstructured Data: Test Result:covid-19 pneumonia
Write-up
Pulmonary congestion, ARDS, cardiac decompensation; Pulmonary congestion, ARDS, cardiac decompensation; Pulmonary congestion, ARDS, cardiac decompensation; COVID-19; COVID-19 pneumonia; Vaccination failure; This is a spontaneous report from a non-contactable consumer downloaded from the Regulatory Authority-WEB, regulatory authority number DE-PEI-CADR2021079508, Sender's (Case) Safety Report Unique Identifier DE-PEI-202100072522.
An 84-year-old female patient received bnt162b2 (COMIRNATY, 0.
3 ml), dose 2 via an unspecified route of administration on 19Feb2021 (Batch/Lot Number: EP9598) as single dose, dose 1 via an unspecified route of administration on 28Jan2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation.
Medical history included type II diabetes mellitus, CHD (coronary artery disease).
Concomitant medications included furosemide; meropenem trihydrate (MERONEM); enoxaparin sodium (CLEXANE); insulin glulisine (APIDRA).
On 27Feb2021 the patient experienced pulmonary congestion (fatal, hospitalization), ARDS (acute respiratory distress syndrome) (death, hospitalization), Vaccination failure, COVID-19, COVID-19 pneumonia, Decompensated heart failure.
The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 27Feb2021, x-ray: covid-19 pneumonia on 27Feb2021.
The affected person was hospitalized and died.
She received both vaccinations with Comirnaty.
One week after the second vaccination, a Covid-19 infection was detected by means of PCR (27Feb2021).
Sequencing was not performed.
Symptoms (from 27Feb2021): Covid pneumonia (confirmed by X-rays), pulmonary congestion, Acute Respiratory Distress Syndrome, cardiac decompensation.
The person concerned died on 11Mar2021.
An autopsy was not performed.
The patient's outcome reported as fatal for Acute Respiratory Distress Syndrome, fatal for Decompensated heart failure, not recovered for other events.
This report is serious - death.
Sender Comment: Information on risk factors or previous illnesses.
Comirnaty/ all events/ Regulatory Authority/ Unclassifiable.
No follow-up attempts possible.
No further information expected.
; Reported Cause(s) of Death: Vaccination failure; Decompensated heart failure; Pulmonary congestion; COVID-19; COVID-19 pneumonia; ARDS