Adverse Event Reporting

VAERS ID	1488790
Gender	Male
Age
StateCode	FR
Pharmaceutical Company	PFIZER\BIONTECH
Lot Number	FC3098
Number of vaccinations	2
Vaccinated	2021-06-14
Onset	2021-06-17
Condition	Died

Symptoms

• Cardiac arrest

Current Illness

Preexisting Conditions

Medical History/Concurrent Conditions: Diabetes; Hypertension arterial; Hypertensive heart disease; Myocardial ischaemia

Other Medications

CARDIOASPIRIN; AMILORIDE HYDROCHLORIDE;HYDROCHLOROTHIAZIDE; METFORMINA ACTAVIS; OLMESARTAN MEDOXOMIL/AMLODIPINE; ATORVASTATINA EG

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Cardiac arrest; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number IT-MINISAL02-751332.
A 67-year-old male patient received the second dose of bnt162b2 (COMIRNATY), intramuscular on 14Jun2021 (Batch/Lot Number: FC3098) as a single dose for COVID-19 immunization.
Medical history included hypertension, diabetes and was on oral antidiabetics from Jun2020, hypertensive heart disease from 01Jun2020 (ejection fraction % left ventricle moderately depressed), and myocardial ischaemia from 06Nov2020; all unknown if ongoing.
Last admission 06Nov2020 for haemodynamic study for myocardial ischaemia induced by a recent stress echo.
Concomitant medications included acetylsalicylic acid (CARDIOASPIRIN); amiloride hydrochloride;hydrochlorothiazide (AMILORIDE HYDROCHLORIDE;HYDROCHLOROTHIAZIDE); metformin hydrochloride (METFORMINA ACTAVIS); amlodipine besilate, olmesartan medoxomil (OLMESARTAN MEDOXOMIL/AMLODIPINE); and atorvastatin calcium (ATORVASTATINA EG).
The patient experienced cardiac arrest on 17Jun2021 and died on the same day.
An autopsy was not performed.
Senders comments: 29Jun2021 Local Responsible of Regulatory Authority: Further information and autopsy report required.
; Reported Cause(s) of Death: Cardiac arrest