이상반응 보고

VAERS ID	2138175
성별	남성
나이
주 코드	FR
제약회사	PFIZER\BIONTECH
로트 번호	ACB5038
예방접종 횟수	3
접종일	2022-01-05
발병일	2022-02-09
상태	입원 사망

증상

• 부정맥(Arrhythmia)

이환 중 질병

Coronary artery disease

지병

Medical History/Concurrent Conditions: Coronary heart disease; Diabetes; Hypertension; Overweight

기타 의료

이전 예방접종

알레르기

임상 검사

증상 상세

Exitus lethalis in malignant cardiac arrhythmias; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP) from the RA.
Regulatory number: DE-PEI-CADR2022274434.
Other Case identifier(s): DE-CADRPEI-2022274434 (RA Webportal), DE-PEI-202200076083.
A 55 year-old male patient received bnt162b2 (COMIRNATY), administration date 05Jan2022 (Lot number: ACB5038) as dose 3 (booster), 0.
3 ml single for covid-19 immunisation.
Relevant medical history included: "Coronary artery disease" (ongoing); "Diabetes" (unspecified if ongoing); "coronary heart disease" (unspecified if ongoing); "hypertension" (unspecified if ongoing); "overweight" (unspecified if ongoing).
The patient's concomitant medications were not reported.
Vaccination history included: Covid-19 vaccine (1st dose, MANUFACTURER UNKNOWN), for covid-19 immunisation; Covid-19 vaccine (2nd dose, MANUFACTURER UNKNOWN), for covid-19 immunisation.
The following information was reported: ARRHYTHMIA (death, hospitalization) with onset 09Feb2022, outcome "fatal", described as "Exitus lethalis in malignant cardiac arrhythmias".
The patient was hospitalized for arrhythmia (start date: 09Feb2022).
The patient date of death was 10Feb2022.
The reported cause of death was arrhythmia.
It was not reported if an autopsy was performed.
Relatedness between COMIRNATY and the event was assessed by RA as unclassifiable.
No follow-up attempts are possible.
No further information is expected.
; Reported Cause(s) of Death: Exitus lethalis in malignant cardiac arrhythmias