VAERS ID: 1953856

AGE: 17| SEX: M|State: FR

Description

unresponsive; Death; This is a spontaneous report received from a contactable reporter(s) (Other HCP) from Regulatory Authority. Regulatory number: PH-PHFDA-300121782 (Regulatory Authority). A 17 years old male patient received bnt162b2 (COMIRNATY), intramuscular, administration date 15Nov2021 (Lot number: 32025BD) at the age of 17 years as dose number unknown, single for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: UNRESPONSIVE TO STIMULI (death) with onset 18Nov2021 09:00, outcome "fatal", described as "unresponsive". The patient date of death was unknown. The reported cause of death was unresponsive to stimuli. 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: death; Unresponsive

Symptoms

Death, Unresponsive to stimuli

Vaccines

VAX DATE: 14 November 2021 | ONSET DATE: 17 November 2021 | DAYS TO ONSET: 3
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))

        RECVDATE:
        15 December 2021
        CAGE_YR:
        CAGE_MO:
        RPT_DATE:
        DIED:
        Y
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        N
        LAB_DATA:
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        PHPFIZER INC202101711250
        FORM_VERS:
        2
        TODAYS_DATE:
        14 December 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY: