Adverse Event Reporting
| VAERS ID | 1959861 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | FC3095 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-24 |
| Onset | 2021-06-24 |
| Condition | Died |
Symptoms
- Tremor
- Nausea
- Visual impairment
- Malaise
- Pruritus
- Somnolence
- Death
Current Illness
COPD; Diabetes mellitus
Preexisting Conditions
Medical History/Concurrent Conditions: Coronary heart disease
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
Nausea; drowsiness; Unknown cause of death; tremor hand; Malaise; visual disturbances; Itch; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP) from the Regulatory Authority-WEB.
Regulatory number: DE-PEI-CADR2021209464.
Other Case identifier(s): DE-CADRPEI-2021209464, DE-PEI-202100261598.
A 84 year-old female patient received bnt162b2 (COMIRNATY), administration date 24Jun2021 (Lot number: FC3095) as dose 2, single for covid-19 immunisation.
Relevant medical history included: "COPD" (ongoing); "Diabetes mellitus" (ongoing); "coronary heart disease" (unspecified if ongoing).
There were no concomitant medications.
Vaccination history included: Comirnaty (1st dose, 0.
3 ml), administration date: 24May2021, for Prophylactic vaccination.
The following information was reported: DEATH (death) with onset 09Jul2021, outcome "fatal", described as "Unknown cause of death"; TREMOR (non-serious) with onset 24Jun2021, outcome "not recovered", described as "tremor hand"; MALAISE (non-serious) with onset 24Jun2021, outcome "not recovered", described as "Malaise"; VISUAL IMPAIRMENT (non-serious) with onset 24Jun2021, outcome "not recovered", described as "visual disturbances"; PRURITUS (non-serious) with onset 24Jun2021, outcome "not recovered", described as "Itch"; NAUSEA (non-serious), outcome "unknown", described as "Nausea"; SOMNOLENCE (non-serious), outcome "unknown", described as "drowsiness".
The patient date of death was 09Jul2021.
The reported cause of death was "Unknown cause of death".
It was unknown if an autopsy was performed.
The Regulatory Authority assessed the causality of the events with the vaccine as unclassifiable.
; Sender's Comments: Linked Report(s) : DE-PFIZER INC-202101733826 the same patient, another dose of vaccine, another events; Reported Cause(s) of Death: Unknown cause of death