Page breadcrumb nav

VAERS Report 2157351

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Oui
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: ex0893


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-04-17
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

heart failure in hypertensive patient.; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: it-minisal02-843200. a 84 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 17apr2021 (lot number: ex0893) as dose 2, single for covid-19 immunisation. relevant medical history included: "chronic renal insufficiency" (unknown if ongoing), notes: stage iii; "hypertension arterial" (unknown if ongoing). the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1, lot er9470, time 14:46, left deltoid), administration date: 27mar2021, for covid-19 immunization. the following information was reported: cardiac failure (death, medically significant) with onset 18apr2021, outcome "fatal", described as "heart failure in hypertensive patient.". the patient date of death was 18apr2021. the reported cause of death was cardiac failure. autopsy result 15feb2021, death following adverse effect induced by comirnaty vaccine (pfizer) second dose given less than 24 hours earlier. no follow-up attempts are possible. no further information is expected.; reported cause(s) of death: cardiac failure

Données de laboratoire
na
Liste des symptômes
cardiac failure
Patient décédé?
Oui
Date de décès
2021-04-18
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na