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VAERS ID: 1000476

AGE: 88| SEX: F|State: FR

Description

Dead; FEVER; Blood sugar decreased; This is a spontaneous report from a contactable nurse received from Regulatory Authority, downloaded from the Regulatory Authority-WEB (SE-MPA-2021-000794, other case identifier: SE-MPA-1611147230356). An 88-year-old female patient received BNT162B2 (COMIRNATY; Lot number EL1484) intramuscular in Jan2021 at 0.3 mL single for COVID-19 immunisation. Relevant medical history included diabetes mellitus from an unknown date and unknown if ongoing. Concomitant medications included candesartan cilexetil (CANDEXETIL) from 08Sep2020, ferrous sulfate (DUROFERON) from 10Mar2020, pantoprazole sodium sesquihydrate (PANTOLOC) from 10Mar2020, linagliptin (TRAJENTA) from 01Dec2020, amlodipine from 08Sep2020, atorvastatin from 10Mar2020, bisoprolol from 21Nov2020, clopidogrel from 10Mar2020 and metformin from 21Nov2020. In Jan2021, the patient experienced fever, decreased blood sugar and died. According to the rapporteur, the female developed fever in the afternoon the same day as she got vaccinated with BNT162B2, during the night her blood sugar decreased. She was sent to hospital and died two days after vaccination with BNT162B2. The patient died in Jan2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: death

Symptoms

Blood glucose decreased, Death, Pyrexia

Vaccines

VAX DATE: 31 December 2020 | ONSET DATE: 31 December 2020 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK
  • OT
  • EL1484

RECVDATE:
03 February 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
31 December 2020
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
V_ADMINBY:
OTH
OTHER_MEDS:
BISOPROLOL; DUROFERON; PANTOLOC [PANTOPRAZOLE SODIUM SESQUIHYDRATE]; CLOPIDOGREL; AMLODIPINE; CANDEXETIL; ATORVASTATIN; METFORMIN; TRAJENTA
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Diabetes
PRIOR_VAX:
SPLTTYPE:
SEPFIZER INC2021089170
FORM_VERS:
2
TODAYS_DATE:
02 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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