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VAERS ID: 1000263

AGE: UNK| SEX: M|State: FR

Description

died a few days after vaccination; This is a spontaneous report from a contactable physician based on information received by Pfizer from BioNTech medical information, license party for BNT162B2. An elderly male patient of an unknown age received initial dose of BNT162B2 (COMIRNATY) at single dose on 13Jan2021 via an unknown route for Covid-19 immunization. Medical history and concomitant drug were not provided. The physician stated that he vaccinated (initial dose) an elderly male patient with COMIRNATY (on13Jan2021) and the patient died a few days later. It was unknown if an autopsy was performed. Information about lot/batch number was requested.; Sender's Comments: The causal relationship between BNT162B2and the event death cannot be excluded as the information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: died a few days after vaccination

Symptoms

Death

Vaccines

VAX DATE: 13 January 2021 | ONSET DATE: | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))

        RECVDATE:
        04 February 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:
        DEPFIZER INC2021090238
        FORM_VERS:
        2
        TODAYS_DATE:
        03 February 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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