VAERS ID: 2245944

AGE: 84| SEX: M|STATE: CT (United States)

Description

Administered 2nd booster of Pfizer in afternoon on 4/20/22. Patient was alert and stated he felt good and no previous issues with the vaccine. He completed the 15-20 minute observation period without any adverse reactions. When the observation period concluded, the patient exited the clinic with his wife and returned to his vehicle. Shortly afterwards, the patient's wife approached some staff members in the parking lot and reported that her husband was having difficulty breathing and was not responding appropriately to her questions while sitting in the driver's seat of their car. The staff members immediately activated our clinic's emergency response procedure including a 911 notification. When the vaccine team arrived at the vehicle, they found the patient unresponsive in the driver's seat. He had a pulse, shallow breath and was diaphoretic. The team removed the patient from the vehicle, lowering him onto blankets on the ground. Patient's color was grey. Vital signs were monitored every few minutes: BP: 165/79, HR 52, O2 sat 97% on RA BP: 165/89, HR 50, O2 sat 96% on RA BP: 152/79, HR 51, O2 sat 97% on RA BP: 163/82, HR 49, O2 sat 98% on RA BP: 171/80, HR 56, O2 sat 95% on RA EMS arrived and took over management of the patient along with transport to an outside hospital. On 4/21/22 our staff was in contact with the patient's family who informed us that the patient passed away earlier this morning.

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Symptoms

Dyspnoea, Hyperhidrosis, Skin discolouration, Unresponsive to stimuli, Death, Hypopnoea, Hyporesponsive to stimuli

Vaccines

VAX DATE: 04-20-2022| ONSET DATE: 04-20-2022| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 4 COVID19 PFIZER\BIONTECH FJ6369 IM LA

RECVDATE:04-21-2022
RPT_DATE:
CAGE_YR:84
CAGE_MO:
DIED:Y
DATEDIED:04-21-2022
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Unknown - patient was transferred to an outside hospital.
V_ADMINBY:PVT
OTHER_MEDS:Patient reported being on a blood thinner and a beta blocker. No other medications reported.
CUR_ILL:No illnesses reported. Patient replied "no" to question #1 on the pre-vaccination questionnaire (Are you feeling sick today?).
HISTORY:Patient's wife reports patient having a cardiac history. No other chronic or long-standing health conditions reported.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:04-21-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:No allergies reported.
V_FUNDBY:

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