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VAERS Report 2157364

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

State: Outside US

Patient Died?
Yes
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fg3739


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-09-23
Date of Onset
57
Number of days (onset date – vaccination date)
57
Adverse Event Description

fever; exsaturation; sub acute myeloid leukemia with no mention of remission; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the agency agency-web. regulatory number: it-minisal02-843371. a 83 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm right, administration date 23sep2021 (lot number: fg3739, expiration date: 31mar2022) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: comirnaty (dose 1, lot fg4493, exp 30jan2022), administration date: 02sep2021, for covid-19 immunization. the following information was reported: myeloid leukaemia (death, medically significant) with onset 19nov2021, outcome "fatal", described as "sub acute myeloid leukemia with no mention of remission"; pyrexia (hospitalization), outcome "unknown", described as "fever"; oxygen saturation decreased (hospitalization), outcome "unknown", described as "exsaturation". the patient was hospitalized for pyrexia, oxygen saturation decreased (start date: 22nov2021). the patient underwent the following laboratory tests and procedures: blood lactate dehydrogenase: 752, notes: unit: u/l; fibrin d dimer: 12.797 ng/ml; platelet count (130-500): 25, notes: unit: u/l; troponin i: 945 ng/ml. the patient date of death was unknown. the reported cause of death was "unknown cause of death". it was not reported if an autopsy was performed. clinical information: impact on quality of life (10/10) reporter comment: before the second dose of vaccine in good health due to age and health situation. admitted on 22nov2021 as per medical record: symptoms of fever and exsaturation, the patient with suspected uti. no follow-up attempts are possible. no further information is expected.; reported cause(s) of death: unknown cause of death

Lab Data
test name: ldh; result unstructured data: test result:752; comments: unit: u/l; test name: d-dimer; result unstructured data: test result:12.797 ng/ml; test name: platelet consumption; result unstructured data: test result:25; comments: unit: u/l; test name: troponin i; result unstructured data: test result:945 ng/ml
List of symptoms
pyrexia oxygen saturation decreased troponin i fibrin d dimer platelet count blood lactate dehydrogenase myeloid leukaemia
Patient Died?
Yes
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na