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VAERS ID: 1000269

AGE: UNK| SEX: M|State: FR

Description

Death sudden; This is a spontaneous report received from a contactable physician, downloaded from the Medicines Agency (MA) ES-AEMPS-727019. A 86-year-old male patient received first dose of BNT162B2 (COMIRNATY, Lot number EJ6796) Intramuscular in left arm on 19Jan2021 at single dose for COVID-19 vaccination. Medical history included Hypertension, Hyperuricaemia, Cardiac failure chronic, Chronic kidney disease, Thromboembolic stroke, Fibrillation atrial, Subdural hematoma, Chronic anaemia and Type II diabetes mellitus. Concomitant medications included insulin glargine (LANTUS) for Diabetes mellitus, vildagliptin (GALVUS) for Diabetes mellitus, hydrochlorothiazide for Hypertension, darbepoetin alfa (ARANESP) for Chronic anaemia, fluoxetine hydrochloride (LUMINAL), furosemide for Cardiac failure, calcifediol (HIDROFEROL), calcium polystyrene sulfonate (RESINCALCIO), spironolactone (SPIROLACTONE), atorvastatin, ferrous sulfate (TARDYFERON), alopurinol and omeprazole (OMEPRAZOL). The patient received the first dose of the COVID 19 vaccine and the following morning deceased in his room. Given the patient's medical history, it seemed that it was most likely a sudden death of cardiac origin, given his history, and that it has coincided temporarily with the COVID vaccine. He had no local or general reaction on the day he got the vaccine. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death sudden

Symptoms

Death, Sudden cardiac death

Vaccines

VAX DATE: 18 January 2021 | ONSET DATE: 19 January 2021 | DAYS TO ONSET: 1
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • OT
  • LA
  • EJ6796

RECVDATE:
03 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:
LANTUS; GALVUS; HYDROCHLOROTHIAZIDE; ARANESP; LUMINAL [FLUOXETINE HYDROCHLORIDE]; FUROSEMIDE; HIDROFEROL; RESINCALCIO; SPIROLACTONE; ATORVASTATIN; TARDYFERON; ALOPURINOL; OMEPRAZOL
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Cardiac failure chronic (Cardiovascular disease (excluding hypertension)); Chronic anaemia; Chronic kidney disease; Fibrillation atrial; Hypertension (HTA); Hyperuricaemia; Subdural hematoma; Thromboembolic stroke; Type II diabetes mellitus (Type II diabetes)
PRIOR_VAX:
SPLTTYPE:
ESPFIZER INC2021088719
FORM_VERS:
2
TODAYS_DATE:
02 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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