Adverse Event Reporting
| VAERS ID | 2013995 |
|---|---|
| Gender | Male |
| Age | |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EW2239 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-04-10 |
| Onset | 2021-10-05 |
| Condition | Died |
Symptoms
- SARS-CoV-2 test
- COVID-19
- Vaccination failure
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Date: 20211005; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant Sequenced: B.
1.
617.
2 n501y-positive: No
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-2021-066884.
A 71 year-old male patient received bnt162b2 (COMIRNATY), intramuscular, administration date 20Mar2021 (Lot number: ET1831) as dose 1, single and intramuscular, administration date 10Apr2021 (Lot number: EW2239) as dose 2, single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
The following information was reported: VACCINATION FAILURE (death), COVID-19 (death) all with onset 05Oct2021, outcome "fatal" and all described as "SARS-CoV-2 infection".
The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (05Oct2021) positive, notes: Variant Sequenced: B.
1.
617.
2 n501y-positive: No.
The patient date of death was unknown.
The reported cause of death was covid-19, vaccination failure.
It was not reported if an autopsy was performed.
No follow-up attempts are possible.
No further information is expected.
; Reported Cause(s) of Death: SARS-CoV-2 infection; SARS-CoV-2 infection