Adverse Event Reporting
| VAERS ID | 1486386 |
|---|---|
| Gender | Male |
| Age | 73 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | PC1436 |
| Number of vaccinations | |
| Vaccinated | 2021-06-25 |
| Onset | 2021-06-26 |
| Condition | Hospitalized Died |
Symptoms
- Malaise
- SARS-CoV-2 test
- Chest X-ray
- COVID-19
- Death
- Oxygen saturation
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Asthma; Diarrhoea; Lung mass (suspicious lesion on CXR); Prostate cancer
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Name: CXR; Result Unstructured Data: Test Result:very suggestive of covid-19; Test Name: oxygen saturation; Test Result: 74 %; Test Date: 20210626; Test Name: SARS-CoV-2 Rapid antigen; Result Unstructured Data: Test Result:positive
Write-up
feeling unwell; very suggestive of covid-19, sars-cov-2 rapid antigen test: positive on 26Jun2021; Death; This is a spontaneous report from a contactable physician.
A 73-year-old male patient received BNT162B2 (BNT162B2) on 25Jun2021 (Batch/Lot Number: PC1436) (at the age of 73 years) as dose number unknown, single for covid-19 immunization.
Medical history included asthma, diarrhoea, invasive prostate cancer, pulmonary mass (suspicious lesion on CXR).
The patient's concomitant medications were not reported.
The patient experienced death on 29Jun2021, patient presented to the emergency unit with history of diarrhoea and feeling unwell on an unspecified date.
The patient was hospitalized from 26Jun2021 to an unknown date.
The patient underwent lab tests and procedures which included chest x-ray: very suggestive of covid-19, sars-cov-2 rapid antigen test: positive on 26Jun2021, oxygen saturation: 74%.
The patient died on 29Jun2021.
An autopsy was not performed.
This is the only information available for this report.
The outcome of events was fatal.
; Sender's Comments: As there is limited information in the case provided, the causal association between the event and the suspect drug cannot be excluded.
The case will be reassessed once new information is available.
The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events.
Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.
; Reported Cause(s) of Death: feeling unwell; very suggestive of covid-19, sars-cov-2 rapid antigen test: positive on 26Jun2021; Death