![]() ![]() The deceased patient was 154 cm tall and weighed 43 kg. An autopsy was performed the following day to evaluate the cause of sudden death. The day after the second dose on 3rd October 2021, she missed school because she had a fever of less than 38 ☌. After the first dose of vaccine on 12th September 2021, she had arm pain without fever. She died 45 h after the third vaccination. ![]() The patient was in cardiopulmonary arrest when the ambulance crew arrived at their house and attempts to administer advanced life support were unsuccessful. The following morning, her mother noticed that she was not breathing and had a pale appearance, and she immediately called an ambulance. Her sister, who had slept with her that night, reported that she woke up briefly because she was having difficulty in breathing, talked with her sister, and went to bed soon after. The day after vaccination, she developed a fever of 37.9 ☌, which resolved by the same evening. Despite her history of orthostatic dysregulation, she was healthy by nature and was active in her middle school athletic team. In sudden post-vaccination deaths, aggressive autopsy systemic search and histological examination involving extensive sectioning of the heart, including the atrium, are indispensable.Ī 14-year-old Japanese girl received a third dose of the BNT1262b2 mRNA COVID-19 vaccine/Pfizer (Comirnaty®) on 10th August 2022. In the present case, arrhythmia of atrial origin was assumed as the cause of cardiac failure and death. Although neither type of inflammation is fatal by itself, arrhythmia is reported to be the most common cause of death in patients with atrial myopericarditis. Since there was no preceding infection, allergy, or drug toxicity exposure, the patient was diagnosed with post-vaccination pneumonia, myopericarditis, hepatitis, nephritis, gastroenteritis, cystitis, and myositis. Autopsy findings showed congestive edema of the lungs, T-cell lymphocytic and macrophage infiltration in the lungs, pericardium, and myocardium of the left atria and left ventricle, liver, kidneys, stomach, duodenum, bladder, and diaphragm. A 14-year-old Japanese girl died unexpectedly 2 days after receiving the third dose of the BNT1262b2 mRNA COVID-19 vaccine.
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