이상반응 보고
| VAERS ID | 2013288 |
|---|---|
| 성별 | 남성 |
| 나이 | 59세 |
| 주 코드 | FR |
| 제약회사 | PFIZER\BIONTECH |
| 로트 번호 | FE8206 |
| 예방접종 횟수 | 2 |
| 접종일 | 2021-08-04 |
| 발병일 | 2021-08-01 |
| 상태 | 사망 |
증상
- 뇌혈관 사고(Cerebrovascular accident)
- 체온(Body temperature)
이환 중 질병
Aortic dissection (Being treated in other hospital.); Oesophageal carcinoma (Being treated in other hospital.); Pharyngeal cancer (Being treated in other hospital.)
지병
기타 의료
WARFARIN
이전 예방접종
알레르기
임상 검사
Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: Test Result:36.
6 Centigrade; Comments: before vaccination
증상 상세
Stroke; This is a spontaneous report from a contactable physician received from the Regulatory authority, report number is v21132421.
A 59-year and 10-month-old male on 04Aug2021 in the afternoon (the day of vaccination), the patient received the second dose of BNT162b2 (COMIRNATY,Solution for injection), administration date 04Aug2021 (Lot number: FE8206, Expiration Date: 31Jan2022) via an unspecified route of administration at the age of 59 years as dose 2, single for covid-19 immunisation.
Relevant medical history included: "Aortic dissection" (ongoing), notes: Being treated in other hospital.
; "Oesophageal carcinoma" (ongoing), notes: Being treated in other hospital.
; "Pharyngeal cancer" (ongoing), notes: Being treated in other hospital.
The vaccine screening questionnaire (primary diseases, allergies, vaccinations, and illnesses within the last one month, medications the patient was taking, past adverse effect history, growth status) included: The patient was taking oral WARFARIN.
Concomitant medication(s) included: WARFARIN (ongoing).
Vaccination history included: On an unspecified date, the patient previously received the first dose of BNT162b2 Comirnaty (dose 1, single, Lot Number: EY0583, Expiration date:31Jan2022), for COVID-19 immunisation.
The following information was reported: On an unspecified date in Aug2021 (after the vaccination), the patient experienced unspecified event.
On 18Aug2021 (14 days after the vaccination), the patient died by stroke.
CEREBROVASCULAR ACCIDENT (death, medically significant) with onset Aug2021, outcome "fatal", described as "Stroke".
The patient underwent the following laboratory tests and procedures: body temperature: (04Aug2021) 36.
6 Centigrade, notes: before vaccination.
The patient date of death was 18Aug2021.
The reported cause of death was cerebrovascular accident.
It was not reported if an autopsy was performed.
The course of the event was as follows: On 03Sep2021, the family of the patient connected and told that the patient died of Stroke.
Because the patient did not receive treatment in our hospital, details were unknown.
The patient was being treated in other hospital because of Aortic dissection, Oesophageal carcinoma, Pharyngeal cancer.
The reporting physician classified the event as serious (Death) and assessed the causality between the event and BNT162b2 as unassessable.
No follow-up attempts are possible.
No further information is expected.
; Reported Cause(s) of Death: Stroke