VAERS ID: 2174647

AGE: 26| SEX: M|STATE: FR (Unknown)

Description

This is a spontaneous report received from a contactable reporter(s) (Other HCP) from Regulatory Authority. Regulatory number: PH-PHFDA-300137346 (RA). A 26 year-old male patient received bnt162b2 (COMIRNATY), intramuscular, administration date 01Dec2021 (Lot number: FL5324) at the age of 26 years as dose number unknown, single for Covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: CARDIAC FAILURE (death, hospitalization, medically significant) with onset 16Feb2022, outcome "fatal", described as "HF"; HYPERTENSION (death, hospitalization) with onset 16Feb2022, outcome "fatal", described as "HPN II"; ADJUSTMENT DISORDER (death, hospitalization), INFECTION (death, hospitalization) all with onset 16Feb2022, outcome "fatal" and all described as "ADJUSTMENT DISORDER INFECTION"; SYSTEMIC VIRAL INFECTION (death, hospitalization) with onset 16Feb2022, outcome "fatal", described as "SVI"; ANIMAL BITE (non-serious), outcome "unknown", described as "DOG BITE". The patient date of death was unknown. The reported cause of death was hypertension, cardiac failure, adjustment disorder, infection, systemic viral infection. Events were reported as follows: HPN II:R/O HF:T/C ADJUSTMENT DISORDER INFECTION:T/C SVI, DOG BITE. No follow-up attempts are possible. No further information is expected. Reported Cause(s) of Death: ADJUSTMENT DISORDER INFECTION; HPN; HF; ADJUSTMENT DISORDER INFECTION; SVI.

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Infection, Cardiac failure, Hypertension, Adjustment disorder, Animal bite, Systemic viral infection

Vaccines

VAX DATE: 12-01-2021| ONSET DATE: 02-16-2022| DAYS TO ONSET: 77
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH FL5324 OT

RECVDATE:03-12-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PHPFIZER INC202200355178
FORM_VERS:
TODAYS_DATE:03-11-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

Questions? Comments? Bugs?
[email protected]
Due to the high volume of inquiries, please be patient with response times.

AND PLEASE read the FAQ first.

OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.