Adverse Event Reporting
| VAERS ID | 2013824 |
|---|---|
| Gender | Male |
| Age | |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | FD0168 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-15 |
| Onset | 2021-11-05 |
| Condition | Died |
Symptoms
- SARS-CoV-2 test
- COVID-19
- Vaccination failure
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Date: 20211105; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive; Comments: Variant PCR-based: No Information Variant Sequenced: No Information n501y-positive: Unknown
Write-up
SARS-CoV-2 infection; SARS-CoV-2 infection; This is a spontaneous report received from a contactable reporter(s) (Physician) from a regulatory authority.
Regulatory number: AT-BASGAGES-2021-065660.
A 64 year-old male patient received bnt162b2 (COMIRNATY), intramuscular, administration date 15Jun2021 (Lot number: FD0168) as dose 2, single and intramuscular, administration date 11May2021 (Lot number: EY7015) as dose 1, single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
The following information was reported: COVID-19 (death), VACCINATION FAILURE (death) all with onset 05Nov2021, outcome "fatal" and all described as "SARS-CoV-2 infection".
The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (05Nov2021) positive, notes: Variant PCR-based: No Information; Variant Sequenced: No Information; n501y-positive: Unknown.
The patient date of death was unknown.
The reported cause of death was covid-19.
No follow-up attempts are possible.
No further information is expected.
; Reported Cause(s) of Death: SARS-CoV-2 infection