Adverse Event Reporting
| VAERS ID | 1745901 |
|---|---|
| Gender | Female |
| Age | 84 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | FD9234 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-15 |
| Onset | 2021-06-15 |
| Condition | Died |
Symptoms
- Inappropriate schedule of product administration
- Echocardiogram
- Pericarditis
- Pericardial effusion
- Cardiogenic shock
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Name: Echocardiography; Result Unstructured Data: Test Result: unknown result
Write-up
Pericarditis; Effusion pericardial; Shock cardiogenic; Inappropriate schedule of vaccine administered; This is a spontaneous report from a non-contactable physician downloaded from the regulatory authority EudraVigilance-WEB, regulatory authority number DE-PEI-202100189616.
An 84-years-old female patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on 15Jun2021 (Lot Number: FD9234) as dose 2, single at the age of 84-years-old for covid-19 immunization.
The patient medical history was not reported.
The patient's concomitant medications were not reported.
The patient previously took first dose of bnt162b2 on 28Apr2021 for Covid-19 immunisation.
The patient experienced inappropriate schedule of vaccine administered on 15Jun2021 and pericarditis, effusion pericardial, shock cardiogenic on an unspecified date.
The patient underwent lab tests and procedures which included echocardiogram: unknown result.
Outcome of the events pericarditis, effusion pericardial, shock cardiogenic was fatal.
The patient died on an unspecified date.
It was not reported if an autopsy was performed.
Result of Assessment: Comirnaty/ event(s): pericarditis, effusion pericardial, shock cardiogenic/ PEI: D.
Unclassifiable No follow-up attempts possible.
No further information expected.
; Reported Cause(s) of Death: Cardiogenic shock; Effusion pericardial; shock cardiogenic