이상반응 보고

VAERS ID 920545
성별 남성
나이 93세
주 코드 SD
제약회사 PFIZER\BIONTECH
로트 번호 EL0140
예방접종 횟수 1
접종일 2021-01-04
발병일 2021-01-04
상태 사망
증상
  • 피로(Fatigue)
  • 사지 불편(Limb discomfort)
  • 호흡 정지(Respiratory arrest)
  • 혈압 비정상(Blood pressure abnormal)
  • 맥박 없음(Pulse absent)
  • 비정상적인 행동(Abnormal behaviour)

이환 중 질병

지병

ACUTE POSTHEMORRHAGIC ANEMIA, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH OTHER FORMS OF ANGINA PECTORIS, CARDIAC MURMUR, UNSPECIFIED, CHRONIC KIDNEY DISEASE, STAGE 2, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, EMPHYSEMA, ESSENTIAL (PRIMARY) HYPERTENSION, FRACTURE OF NASAL BONES, INITIAL ENCOUNTER FOR CLOSED FRACTURE, HYPOXEMIA, PAROXYSMAL ATRIAL FIBRILLATION, PRESENCE OF CARDIAC PACEMAKER, THROMBOCYTOPENIA, UNSPECIFIED CIRRHOSIS OF LIVER, and UNSPECIFIED DIASTOLIC (CONGESTIVE) HEART FAILURE.

기타 의료

Ferrex 150 mg, Folic Acid 1 mg, Furosemide 20 mg, Isosorbide Mononoitrate ER 30 mg, Lactulose 15 mL, Omeprazole 40 mg, Potassium Chloride ER 20 MEQ, Metoprolol 12.5 mg, PreserVision AREDS 2 one capsule, Ranolazine ER 1,000 mg, and Sucralf

이전 예방접종

알레르기

NKA

임상 검사

증상 상세

The resident received is vaccine around 11:00 am and tolerated it without any difficulty or immediate adverse effects.
He was at therapy from 12:36 pm until 1:22 pm when he stated he was too tired and could not do anymore.
The therapist took him back to his room at that time and he got into bed himself but stated his legs felt heavy.
At 1:50 pm the CNA answered his call light and found he had taken himself to the bathroom.
She stated that when he went to get back into the bed it was "abnormal" how he was getting into it so she assisted him.
At that time he quit breathing and she called a RN into the room immediately.
He was found without a pulse, respirations, or blood pressure at 1:54 pm.
He was a DNR.