VAERS ID: 1114558

AGE: 41| SEX: M|STATE: FR (United Arab Emirates)

Description

Death sudden; This is a spontaneous report from a contactable consumer. A 41-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), the first dose on 18Jan2021 and the second dose on 06Feb2021, both via an unspecified route of administration at single dose for COVID-19 immunisation. Medical history included epilepsy (controlled). No allergies to medications, food, or other products. Concomitant medication included valproate sodium (DEPAKENE [VALPROATE SODIUM]). The patient experienced death sudden on 02Mar2021. The patient died on 02Mar2021. The event required a visit to the emergency room. An autopsy was performed. Reporter stated that: "I want to report that 3 weeks after receiving the second vaccination a healthy 41 year old male passed away suddenly last week. A post mortem is currently being carried out but this needs to be reported and logged as I am not sure how a post mortem would see if the vaccine had any impact on his death". Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. The information on the Lot / Batch number has been requested.; Reported Cause(s) of Death: Death sudden

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Symptoms

Sudden death

Vaccines

VAX DATE: 02-06-2021| ONSET DATE: 03-02-2021| DAYS TO ONSET: 24
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH Unknown Unknown LA

RECVDATE:03-19-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:03-02-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:DEPAKENE [VALPROATE SODIUM]
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Epilepsy (controlled)
PRIOR_VAX:
SPLTTYPE:AEPFIZER INC2021257223
FORM_VERS:
TODAYS_DATE:03-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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