Adverse Event Reporting
| VAERS ID | 2063750 |
|---|---|
| Gender | Female |
| Age | 43 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | |
| Number of vaccinations | |
| Vaccinated | 2021-06-25 |
| Onset | 2021-06-25 |
| Condition | Hospitalized Died |
Symptoms
- Sepsis
- Death
- Pancreatitis
- Renal failure
- Dependence on respirator
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
septic; kidney failure; 1d after vaccination pancreatitis, possibly stone-induced; requires ventilation within 3 days; death after 7 weeks in intensive care unit; This is a spontaneous report received from a non-contactable reporter (Physician) from the Regulatory Authority-WEB.
Regulatory number: DE-PEI-CADR2021183424.
Other Case identifier(s): DE-CADRPEI-2021183424, DE-PEI-202200035471.
A 43 year-old female patient received BNT162b2 (COMIRNATY), administration date 25Jun2021 (Lot number: Unknown) at the age of 43 years as dose number unknown, single for covid-19 immunisation.
Relevant medical history included: (ongoing).
The patient's concomitant medications were not reported.
The following information was reported: DEATH (death) with onset 04Jul2021, outcome "fatal", described as "death after 7 weeks in intensive care unit"; SEPSIS (hospitalization) with onset 25Jun2021, outcome "not recovered", described as "septic"; RENAL FAILURE (hospitalization) with onset 25Jun2021, outcome "not recovered", described as "kidney failure"; PANCREATITIS (hospitalization) with onset 25Jun2021, outcome "not recovered", described as "1d after vaccination pancreatitis, possibly stone-induced"; DEPENDENCE ON RESPIRATOR (hospitalization) with onset 25Jun2021, outcome "not recovered", described as "requires ventilation within 3 days".
The patient date of death was 04Jul2021.
The reported cause of death was "Unknown cause of death".
It was not reported if an autopsy was performed.
Sender Comment: Are you or the person concerned known of any allergies? If yes, which? No.
Information on risk factors or previous illnesses: Obesity.
The patient was in the intensive care unit in the PRIVACY Clinic for 7 weeks, I am only a relative, but as a resident internist myself, I work as a vaccination doctor, according to the husband, the clinic did not report to Regulatory Authority.
No follow-up attempts are possible; information about lot/batch number cannot be obtained.
No further information is expected.
; Reported Cause(s) of Death: Unknown cause of death