Page breadcrumb nav

VAERS Report 2157405

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Oui
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: unknown


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-04-15
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

access to the emergency room by ambulance where cerebral ischemia is found; consequent death from septicemia; consequent death from septicemia; post vaccine fever at 40 centigrade; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: it-minisal02-845659 (agency). a 82 year-old male patient received bnt162b2 (comirnaty), administration date 15apr2021 (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. relevant medical history included: "myelodiplastic syndrome with excess blasts and plateletphy" (unspecified if ongoing). the patient's concomitant medications were not reported. the following information was reported: cerebral ischaemia (death, medically significant) with onset 16apr2021, outcome "fatal", described as "access to the emergency room by ambulance where cerebral ischemia is found"; death (death, medically significant), sepsis (death, medically significant) all with onset 16apr2021, outcome "fatal" and all described as "consequent death from septicemia"; pyrexia (death) with onset 16apr2021, outcome "fatal", described as "post vaccine fever at 40 centigrade". the events "access to the emergency room by ambulance where cerebral ischemia is found", "consequent death from septicemia" and "post vaccine fever at 40 centigrade" were evaluated at the emergency room visit. the patient underwent the following laboratory tests and procedures: body temperature: (16feb2021) 40 centigrade, notes: fever. the patient date of death was 18apr2021. the reported cause of death was sepsis. it was not reported if an autopsy was performed. reporter comment: influenza vaccination was not carried out - concomitant conditions: myelodyplastic syndrome with excess blasts and plateletphy - sent by agency. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected.; reporter's comments: influenza vaccination was not carried out - concomitant conditions: myelodyplastic syndrome with excess blasts and plateletphy - sent by agency; reported cause(s) of death: septicaemia

Données de laboratoire
test date: 20210216; test name: body temperature; result unstructured data: test result:40 centigrade; comments: fever
Liste des symptômes
sepsis pyrexia cerebral ischaemia death body temperature
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