Adverse Event Reporting
| VAERS ID | 2013460 |
|---|---|
| Gender | Female |
| Age | 82 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | |
| Number of vaccinations | 3 |
| Vaccinated | 2021-12-12 |
| Onset | 2021-12-12 |
| Condition | Died |
Symptoms
- Chills
- Malaise
- Immunisation
- Cardiac arrest
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
booster; Died of cardiac arrest within 24 hours after vaccination; immediately after vaccination shivering; immediately after vaccination general malaise; This is a spontaneous report from a contactable consumer from the Agency Agency-WEB.
Regulatory number: NL-LRB-00729243.
An 82-year-old female patient received BNT162b2 (COMIRNATY), administration date 12Dec2021 at the age of 82 years as dose 3 (booster), single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
Vaccination history included: Comirnaty (dose 1), for covid-19 immunisation, reaction(s): "flu-like symptoms"; Comirnaty (dose 2), for covid-19 immunisation, reaction(s): "flu-like illness"; "also unable to stand and walk independently".
The following information was reported: immunisation (death) with onset 12Dec2021, outcome "fatal", described as "booster"; cardiac arrest (death) with onset 12Dec2021, outcome "fatal", described as "died of cardiac arrest within 24 hours after vaccination"; chills (non-serious) with onset 12Dec2021, outcome "unknown", described as "immediately after vaccination shivering"; malaise (non-serious) with onset 12Dec2021, outcome "unknown", described as "immediately after vaccination general malaise".
Patient died within 24 hours of vaccination.
Diagnostic procedures was no.
Confouding factor was no.
The patient date of death was 13Dec2021.
The reported cause of death was cardiac arrest.
It was not reported if an autopsy was performed.
No follow-up attempts are possible; information about lot/batch number cannot be obtained.
No further information is expected.
; Reported Cause(s) of Death: Cardiac arrest after booster vaccination