Adverse Event Reporting
| VAERS ID | 1476797 |
|---|---|
| Gender | Female |
| Age | 47 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | FD7959 |
| Number of vaccinations | 1 |
| Vaccinated | 2021-06-25 |
| Onset | 2021-06-25 |
| Condition | Died |
Symptoms
- Respiratory failure
- Cardio-respiratory arrest
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Asthma; Smoker
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
47-year-old patient vaccinated with the first dose of anti covid pfizer at 2.
36 pm, suffered respiratory failure and went into cardio respiratory arrest at about 5.
45 pm with subsequent death; 47-year-old patient vaccinated with the first dose of anti covid pfizer at 2.
36 pm, suffered respiratory failure and went into cardio respiratory arrest at about 5.
45 pm with subsequent death; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB:IT-MINISAL02-750553.
A 47-year-old female patient received bnt162b2 (COMIRNATY), dose 1 intramuscular, administered in left shoulder on 25Jun2021 14:36 at the age of 47-year-old (Batch/Lot Number: FD7959; Expiration Date: 31Oct2021) as single dose for COVID-19 immunisation.
Medical history included asthma, tobacco user.
The patient's concomitant medications were not reported.
The patient experienced respiratory failure and went into cardio respiratory arrest at about 5.
45 pm with subsequent death (death) on 25Jun2021 17:45 about 4 hours after vaccination.
He received cardiopulmonary resuscitation at home performed by Emergency operators.
The patient died on 25Jun2021.
It was not reported if an autopsy was performed.
Reporter's comments: 47-year-old patient, about 4 hours after vaccination against covid with the first pfizer dose, presents with acute respiratory failure and cardio-respiratory arrest with subsequent death.
Sender's comments: Once the reporter has been contacted, the death certificate and further documentation 118 (Emergency call) are awaited.
On 30Jun2021, clinical documentation relating to the death is attached.
; Reporter's Comments: 47-year-old patient, about 4 hours after vaccination against covid with the first pfizer dose, presents with acute respiratory failure and cardio-respiratory arrest with subsequent death.
; Reported Cause(s) of Death: 47-year-old patient vaccinated with the first dose of anti covid pfizer at 2.
36 pm, suffered respiratory failure and went into cardio respiratory arrest at about 5.
45 pm with subsequent death; 47-year-old patient vaccinated with the first dose of ant