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VAERS Report 2157372

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

State: Outside US

Patient Died?
Yes
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

administered via subcutaneous route; progressive reduction of mobility in the four limbs with almost simultaneous involvement.; hypaesthesia; asthenia; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. regulatory number: it-minisal02-843563 (ra). a 84 year-old male patient received bnt162b2 (comirnaty), subcutaneous, administered in arm left (lot number: unknown) as dose 2, single for covid-19 immunisation. relevant medical history included: "dm ii" (unspecified if ongoing); "hypercholesterolemia" (unspecified if ongoing); "hypertension" (unspecified if ongoing); "benign prostatic hyperplasia" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (1st dose, single, unknown manufacturer), for covid-19 immunisation. the following information was reported: mobility decreased (death) with onset 16apr2021, outcome "fatal", described as "progressive reduction of mobility in the four limbs with almost simultaneous involvement."; hypoaesthesia (death) with onset 16apr2021, outcome "fatal", described as "hypaesthesia"; asthenia (death) with onset 16apr2021, outcome "fatal", described as "asthenia"; incorrect route of product administration (non-serious), outcome "unknown", described as "administered via subcutaneous route". the patient underwent several specialist medical visits with neurosurgeons and neurologists with associated imaging such as ct and mri (both unknown result) to exclude any reason of organic origin. impact on quality of life (10/10). therapeutic measures were taken as a result of mobility decreased, hypoaesthesia, asthenia which includes steroid therapy for about 30 days which was unsuccessful. the patient date of death was 2021. the reported cause of death was mobility decreased, hypoaesthesia, asthenia. it was unknown if an autopsy was performed. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected.; reporter's comments: not drug allergies. history: dm ii, hypercholesterolemia, hypertension, benign prostatic hyperplasia; reported cause(s) of death: progressive reduction of mobility in the four limbs with almost simultaneous involvement; hypaesthesia; asthenia

Lab Data
test name: ct; result unstructured data: test result:results unknown; test name: mri; result unstructured data: test result:results unknown; test name: impact on quality of life; result unstructured data: test result:10/10
List of symptoms
investigation asthenia hypoaesthesia mobility decreased incorrect route of product administration computerised tomogram magnetic resonance imaging
Patient Died?
Yes
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na