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VAERS ID: 1000401

AGE: UNK| SEX: F|State: FR

Description

PANCREATITIS; This is a spontaneous report from a contactable physician downloaded from the regulatory authority (IE-HPRA-2021-063633). A 91-year-old female patient received the first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 18Jan2021 at single dose for COVID-19 immunisation. Medical history included cerebrovascular accident (CVA), atrial fibrillation, artificial cardiac pacemaker user, dementia, pancreatitis in 2014 and COVID-19 from Apr2020. Concomitant medication included olmesartan medoxomil (OMESAR), lamotrigine (LAMICTAL), Vitamin D, folic acid, apixaban (ELIQUIS), frusemide (FRUSEMIDE), pravastatin, pantoprazole sodium and venlafaxine. The patient experienced pancreatitis on 20Jan2021. The patient had experienced a previous episode of pancreatitis six years prior, in 2014, the cause of which was unknown. The reporter outlined it was unclear if the pancreatitis was related to COMIRNATY. The seriousness for the event was fatal and hospitalization. The patient died in Jan2021. It was not reported if an autopsy was performed. No follow-up attempts possible; information regarding batch/lot cannot be obtained; No further information expected.; Reported Cause(s) of Death: PANCREATITIS

Symptoms

Condition aggravated, Death, Pancreatitis

Vaccines

VAX DATE: 17 January 2021 | ONSET DATE: 19 January 2021 | DAYS TO ONSET: 2
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1

RECVDATE:
03 February 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
31 December 2020
L_THREAT:
ER_VISIT:
HOSPITAL:
Y
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
V_ADMINBY:
OTH
OTHER_MEDS:
VENLAFAXINE; FOLIC ACID; ELIQUIS; PRAVASTATIN; OMESAR [OLMESARTAN MEDOXOMIL]; FRUSEMIDE [FUROSEMIDE]; PANTOPRAZOLE SODIUM; VITAMIN D NOS; LAMICTAL
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Artificial cardiac pacemaker user; Atrial fibrillation; COVID-19; CVA; Dementia; Pancreatitis; Comments: Previous CVA ; AF + Pacemenker Dementia Previous pancreatitis 2014 ? cause Covid 19 04/2020
PRIOR_VAX:
SPLTTYPE:
IEPFIZER INC2021103209
FORM_VERS:
2
TODAYS_DATE:
02 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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