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From the 11/26/2021 release of VAERS data:

Found 2,908 cases where Vaccine is COVID19 and Symptom is COVID-19 and Patient Died

Government Disclaimer on use of this data



Case Details (Sorted by Age)

This is page 13 out of 291

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VAERS ID: 1045000 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-29
Onset:2021-01-05
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   Days after onset: 20
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210105; Test Name: COVID-19; Test Result: Positive
CDC Split Type: ESPFIZER INC2021163688

Write-up: COVID-19; This is a spontaneous report from a contactable consumer. This report was downloaded from Medicines Agency (MA) regulatory authority-WEB and received via Regulatory Authority ES-AEMPS-735202. An elderly (over 65 years old) male patient received the 1st dose bnt162b2 (COMIRNATY) , via an unspecified route of administration on 29Dec2020 at single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced covid-19 (positive for COVID-19) on 05Jan2021 with outcome of fatal. The patient died on 25Jan2021. It was not reported if an autopsy was performed. The cause of death was covid-19. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: COVID-19


VAERS ID: 1045017 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-19
Onset:2021-01-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-30
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic bronchitis; Living in nursing home
Allergies:
Diagnostic Lab Data: Test Date: 20210120; Test Name: PCR SARS-COV 2; Test Result: Positive
CDC Split Type: FRPFIZER INC2021159140

Write-up: COVID-19 aggravated/Fever/ PCR test which turns out to be positive/ suspicion of bronchitis/ deterioration of the patient''s condition; This is a spontaneous report from a contactable other HCP from the Medicines Agency (MA) regulatory authority-WEB FR-AFSSAPS-LY20210485. An 88-year-old male patient received first dose of bnt162b2 (COMIRNATY, lot number: EJ6788), intramuscularly on 19Jan2021 at single dose, for covid-19 immunisation. Medical history included chronic bronchitis, autonomy: GIR 1, and living in nursing home from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. Usual treatment not known. On 19Jan2021, in the morning, 1st injection of bnt162b2, after pre-vaccination consultation. At this time, no symptoms. Stable state of health throughout the day. On 20Jan2021, faced with the presence of a fever at the end of the day, he benefits from a PCR test which turns out to be positive (but the result will not be discovered by the nursing home until 23Jan2021). On 21Jan2021, prescription of antibiotics on suspicion of bronchitis. In the following days, deterioration of the patient''s condition, with several trips to / from the hospital with return to nursing home as soon as the patient''s condition stabilizes. On 28Jan2021, hospitalization. On 30Jan2021, death. COVID-19 cluster in the facility. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 20Jan2021. The outcome of the event was fatal. The patient died on 30Jan2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19 aggravated/Fever/ PCR test which turns out to be positive/ suspicion of bronchitis/ deterioration of the patient''s condition


VAERS ID: 1048262 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Coronavirus test, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-22
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210112; Test Name: coronavirus rapid test; Test Result: Positive
CDC Split Type: DEPFIZER INC2021164941

Write-up: patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; This is a spontaneous report from a non-contactable consumer based on information received by Pfizer from Biontech [manufacturer control number: 15873], license party for Comirnaty.This consumer reported similar events for 39 reports. This is the second of the 39 reports. A 78-year-old patient of an unspecified gender received bnt162b2 (COMIRNATY) lot# EM0477, via an unspecified route of administration on 31Dec2020 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced patient contracted coronavirus on 12Jan2021,symptoms were reported as loss of appetite and weakened. The patient underwent lab tests and procedures which included coronavirus rapid test: positive on 12Jan2021. The patient died on 22Jan2021. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : DE-PFIZER INC-2021164939 same reporter, same drug, different patients, similar events; Reported Cause(s) of Death: patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appet


VAERS ID: 1048263 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2020-12-31
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Coronavirus test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-09
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210105; Test Name: Coronavirus rapid test; Test Result: Positive
CDC Split Type: DEPFIZER INC2021164984

Write-up: patient contractred Coronavirus; This is a spontaneous report from a contactable consumer based on information received by Pfizer from Biontech [manufacturer control number: 15873], license party for Comirnaty. The reporter reported similar events for 39 patients, this is the 15th of 39 reports. A 91-year-old patient of an unspecified gender received 1st dose of bnt162b2 (COMIRNATY, lot number EM0477), via an unspecified route of administration on 31Dec2020 at single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient contractred coronavirus (covid-19) (death) on an unspecified date. The patient underwent lab tests and procedures which included coronavirus rapid test: positive on 05Jan2021. The patient died on 09Jan2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : DE-PFIZER INC-2021164939 same reporter/drug, similar events, different patient; Reported Cause(s) of Death: patient contractred Coronavirus


VAERS ID: 1048268 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CALCIUM & VITAMIN D3; DURAPHAT; KALIUMKLORID ORIFARM; FUROSEMID ORIFARM; BETMIGA; PAMOL; XARELTO; TOILAX; ALNOK; PANTOPRAZOLE TEVA; GANGIDEN; METOPROLOLSUCCINAT HEXAL
Current Illness: COVID-19; General physical health deterioration; Living in nursing home (there was a covid-19 outbreak among several residents and staff.)
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Constipation; Esophageal acid reflux; Heart rate irregular; Hyperactive bladder; Pain
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158654

Write-up: Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) Regulatory Authority-WEB and received via Regulatory Authority DK-DKMA-WBS-0032128. Safety Report Unique Identifier (DK-DKMA-ADR 24692697). An 86-year-old male patient received first dose bnt162b2 (COMIRNATY) Lot # EJ6797, intramuscular on 31Dec2020 at single dose for covid-19 immunisation. Medical history included Esophageal acid reflux, Allergy, Hyperactive bladder, Constipation, Heart rate irregular, pain,ongoing Living in nursing home (there was a covid-19 outbreak among several residents and staff), ongoing general physical health deterioration and ongoing COVID-19. Concomitant medication included calcium carbonate, colecalciferol (CALCIUM & VITAMIN D3) from 07Feb2019 as Calcium supplementation, sodium fluoride (DURAPHAT)from 20Nov2019 as Dental disorder prophylaxis, potassium chloride (KALIUMKLORID ORIFARM) from 14Jan2019 as Potassium supplementation, furosemide (FUROSEMID ORIFARM) from 14Jan2019 as diuretic therapy, mirabegron (BETMIGA) from 02Jun2020 for Hyperactive bladder, paracetamol (PAMOL) from 09Sep2019 for pain, rivaroxaban (XARELTO) from 05Dec2019 as Thrombosis prophylaxis, bisacodyl (TOILAX) from 13Mar2019 for Constipation, cetirizine hydrochloride (ALNOK) from 06Feb2019 for Allergy, pantoprazole sodium sesquihydrate (PANTOPRAZOLE TEVA) from 25-Sep2019 for Esophageal acid reflux, macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (GANGIDEN) from 19Feb2019 for Constipation, metoprolol succinate (METOPROLOLSUCCINAT HEXAL) from 28Feb2019 for Heart rate irregular. The patient experienced death on 05Jan2021. it was not inconceivable that the total liability of covid-19 disease and the vaccination has been fatal for the patient. The patient underwent lab tests and procedures which included COVID-19 virus test: positive in Jan2021. The patient died on 05Jan2021. An autopsy was not performed. The ADRs were by the physician reported as Fatal. Reported cause of death: Death and of/with COVID-19. Only usual confirmation of death was performed post mortem. No findings were reported. If the Medicines Agency receives supplemental significant information regarding this case the case will be re-submitted. Sender Comment: COMMENT from MA: Version 001 has not been submitted to RA. Agency should therefore consider version 2 as the initial report. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient


VAERS ID: 1048269 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Pyrexia, Respiratory failure, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-19
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CALCIUM AND VIT D; MOVICOL [MACROGOL 3350;POTASSIUM CHLORIDE;SODIUM BICARBONATE;SODIUM CHLORIDE]; CENTYL MED KALIUMKLORID; OLANZAPIN STADA; ELOCOM; MAGNESIA [MAGNESIUM HYDROXIDE]; PANTOPRAZOL KRKA; IBUMETIN; PARACETAMOL ORIFARM; SERTRALIN A
Current Illness: COVID-19; General physical health deterioration; Living in nursing home
Preexisting Conditions: Medical History/Concurrent Conditions: Alcohol abuse (for many years before he came to the nursery home); Cerebral haemorrhage (with sequelae (psychosis, burns with ulcer, fungal infec, vomiting blood, haemorrhage, immobility)); Constipation; Depression; Eczema; Edema; Esophageal acid reflux; Mental disorder; Pain; Vitamin D deficiency
Allergies:
Diagnostic Lab Data: Test Date: 20210103; Test Name: COVID-19 virus test; Test Result: Negative ; Test Date: 20210104; Test Name: COVID-19 virus test; Test Result: Inconclusive ; Test Date: 20210106; Test Name: COVID-19 virus test; Test Result: Negative ; Test Date: 20210113; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158652

Write-up: COVID-19; Respiratory failure; Fever; COVID-19 test 13Jan2021: Positive; This is a spontaneous report downloaded from the Agency Regulatory Authority-WEB [DK-DKMA-WBS-0032130]. The case was received from a contactable physician via The Agency. A 70-years-old male patient received first dose of bnt162b2 (COMIRNATY, lot number: EJ6797, Expiration Date: 30Apr2021), intramuscular on 31Dec2020 at single dose for covid-19 immunisation. Medical history included Living in nursing home from 2018 and ongoing, alcohol abuse for many years before he came to the nursery home not ongoing, ongoing covid-19, ongoing general physical health deterioration, cerebral haemorrhage from 2010 not ongoing with sequelae (psychosis, burns with ulcer, fungal infec, vomiting blood, haemorrhage, immobility), vitamin D deficiency, edema, eczema, constipation, mental disorder, esophageal acid reflux, depression, pain. The patient lived in a nursery home and there were a covid-19 outbreak among several residents and staff. Concomitant medication included calcium, colecalciferol (CALCIUM AND VIT D) from 05Mar2017 for Vitamin D deficiency, macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (MOVICOL) from 08Aug2017 for Constipation, bendroflumethiazide, potassium chloride (CENTYL MED KALIUMKLORID) from 23Apr2020 for Edema, olanzapine (OLANZAPIN STADA) from 16Feb2017 for mental disorder, mometasone furoate (ELOCOM) from 02Apr2020 for Eczema, magnesium hydroxide (MAGNESIA) from 04Aug2017 for constipation, pantoprazole sodium sesquihydrate (PANTOPRAZOL KRKA) from 10Sep2020 for Esophageal acid reflux, ibuprofen (IBUMETIN) from 10Sep2020 for pain, paracetamol (PARACETAMOL ORIFARM) from 21Nov2019 for pain, sertraline hydrochloride (SERTRALIN ACCORD) from 06Mar2019 for Depression. Past vaccines included Pneumovax (Pneumococcal vaccine, 23-valent) on 11May2020 and Influenza (Influenza Type A and Influenza Type B vaccine, 4-valent) on 20Oct2020. On 18Jan2021 the patient developed fever and respiratory insufficiency and died on 19Jan2021. The ADRs were by the reporter reported as fatal. Reported cause(es) of death was respiratory insufficiency and COVID 19. The reporter was in doubt about how long the vaccine affected the immune system, the reporter thought that the patient may have a worsening course of the disease with covid due to the vaccine, even though the patient did first become ill 2 weeks after the vaccine. The patient underwent lab tests and procedures which included COVID-19 test 03Jan2021: Negative, 04Jan2021: Inconclusive, 06Jan2021: Negative, 13Jan2021: Positive. The patient died on 19Jan2021. An autopsy was not performed. Only ordinary confirmation of death was performed post-mortem. The reporter stated that it was not inconceivable that the total liability of Covid-19 disease and the vaccination had been fatal for the patient. Senders comment: COMMENT from Agency: Version 001 has not been submitted to Regulatory Authority. Health Authority should therefore consider version 2 as the initial report. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19 test 13Jan2021: Positive; COVID-19; Respiration failure; Fever


VAERS ID: 1048270 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-16
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical health deterioration; Living in nursing home (There was a covid-19 outbreak among several residents and staff)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158644

Write-up: Death with COVID-19/COVID-19 virus test, Jan2021, positive; Death with COVID-19/COVID-19 virus test, Jan2021, positive; This is a spontaneous report from a contactable physician received from the Medicines Agency. Regulatory authority report number DK-DKMA-WBS-0032136. A 91-year-old female patient received the first dose bnt162b2 (COMIRNATY, Batch number/lot number: EJ6797), intramuscular on 31Dec2020 at single dose for covid-19 immunization. The patient''s concurrent conditions included general physical health deterioration, the patient was living in nursing home, where there was a covid-19 outbreak among several residents and staff. The patient''s concomitant medications were not reported. The patient experienced covid-19 in Jan2021. The patient underwent lab tests and procedures which included COVID-19 virus test: positive in Jan2021. The patient died on 16Jan2021. An autopsy was not performed. Reported cause of death was death with COVID-19. The outcome was fatal.; Reported Cause(s) of Death: Death with COVID-19/COVID-19 virus test, Jan2021, positive; Death with COVID-19/COVID-19 virus test, Jan2021, positive


VAERS ID: 1048272 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-06
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, COVID-19, Diarrhoea, Oxygen saturation, Pyrexia, Respiratory failure, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TAMSULOSIN TEVA; PAMOL; GABAPENTIN ORIFARM; AMLODIPIN KRKA; MOVICOL [MACROGOL 3350;POTASSIUM CHLORIDE;SODIUM BICARBONATE;SODIUM CHLORIDE]; COLECALCIFEROL; LAXOBERAL; NITROFURANTOIN "DAK"; MORFIN ABCUR; DURAPHAT; SERTRALIN ORION
Current Illness: Anxiety; Constipation; Dementia; General physical health deterioration; Hypertension; Living in nursing home; Neuropathic pain; Pain; Type II diabetes mellitus; Urination difficulty
Preexisting Conditions: Medical History/Concurrent Conditions: Dental caries; Prophylaxis urinary tract infection; Vitamin D3 deficiency
Allergies:
Diagnostic Lab Data: Test Date: 20210108; Test Name: Body temperature; Result Unstructured Data: Test Result:37.7 Centigrade; Test Date: 20210112; Test Name: Oxygen saturation; Test Result: 94 %; Test Date: 20210103; Test Name: COVID-19 virus test; Test Result: Negative ; Test Date: 20210106; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158638

Write-up: diarrhea but his fluid intake was fine; body temperature: 37.7 centigrade; Respiratory insufficiency; COVID-19; This is a spontaneous report from contactable physician downloaded from the Agency Regulatory-WEB DK-DKMA-ADR 24693280. An 86-years-old male patient received first dose of bnt162b2 (COMIRNATY, lot number: EJ6797), intramuscular on 31Dec2020 at single dose for covid-19 immunisation. Medical history included dementia from 2016 and ongoing, living in nursing home from 2016 and ongoing, ongoing general physical health deterioration, ongoing Type II diabetes mellitus, ongoing hypertension, ongoing neuropathic pain, ongoing anxiety, ongoing difficulty in urination, ongoing pain, ongoing constipation, Vitamin D3 deficiency, Prophylaxis urinary tract infection and Dental caries. Past vaccines included Pneumovax (Pneumococcal vaccine, 23-valent) on 11May2020 and Fluzone (Influenza Type A and Influenza Type B vaccine, 3-valent) on 20Oct2020. Concomitant medication included tamsulosin hydrochloride (TAMSULOSIN TEVA) from 06Apr2016 for urination difficulty, paracetamol (PAMOL) from 02Jun2014 for pain, gabapentin (GABAPENTIN ORIFARM) from 07Nov2019 for Neuropathic pain, amlodipine besilate (AMLODIPIN KRKA) from 11Sep2020 for hypertension, macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (MOVICOL) from 02Jul2015 for constipation, colecalciferol from 11Jan2016 for Vitamin D3 deficiency, sodium picosulfate (LAXOBERAL) from 06Jun2019 for Constipation, nitrofurantoin (NITROFURANTOIN "DAK") from 09Jan2017 for Prophylaxis urinary tract infection, morphine hydrochloride (MORFIN ABCUR) from 18Jan2021 for pain, sodium fluoride (DURAPHAT) from 15Dec2017 for Dental caries, sertraline hydrochloride (SERTRALIN ORION) from 25Jul2016 for Anxiety. On 06Jan2021 the patient was tested positive for COVID-19 and on 07Jan2021 he developed symptoms with weakened respiration treated with oxygen. On 12Jan2021 the patients general conditions was worsened but stabil. He had diarrhea but his fluid intake was fine. The patient was treated with morfine subcutaneously to reduce oxygen consumption. On 20Jan2021 the patient developed respiratory insufficiency and died. Respiratory insufficiency was by the reporter reported as fatal. Reported cause(es) of death was Respiratory insufficiency and of/with COVID 19. The patient underwent lab tests and procedures which included body temperature: 37.7 centigrade on 08Jan2021, oxygen saturation: 94 % on 12Jan2021, COVID-19 virus test: negative on 03Jan2021, positive on 06Jan2021. The patient died on 20Jan2021. An autopsy was not performed. Only ordinary inquest was performed post-mortem on 21Jan2021. The outcome for body temperature: 37.7 centigrade and diarrhea but his fluid intake was fine was unknown. The reporter stated that it was not inconceivable that the total liability of Covid-19 disease and the vaccination had been fatal for the patient. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19; Respiratory insufficiency


VAERS ID: 1048273 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-14
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical health deterioration; Living in nursing home (there was a covid-19 outbreak among several residents and staff)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158633

Write-up: Death; COVID-19/COVID-19 disease; COVID-19/COVID-19 disease; This is a spontaneous report downloaded from the Medicines Agency (MA) Regulatory Authority-WEB [DK-DKMA-WBS-0032141]. The case was received from a contactable physician via The Medicines Agency (MA). An 88-year-old female patient received first dose of BNT162B2 (COMIRNATY, batch/lot number: EJ6797, expiration date: 30Apr2021) intramuscular on 31Dec2020 at single dose for COVID-19 immunisation. Medical history included general physical health deterioration, was living in nursing home (there was a COVID-19 outbreak among several residents and staff), both ongoing. Concomitant medications were not reported. On 14Jan2021 the patient developed death. Reported cause(es) of death: Death and of/with COVID-19. Only normal confirmation of death was performed post mortem. It was reported that it is not inconceivable that the total liability of COVID-19 disease and the vaccination has been fatal for the patient. Lab data included: in Jan2021, COVID-19 virus test was positive. Autopsy was not done. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19/COVID-19 disease; Death; COVID-19/COVID-19 disease


VAERS ID: 1048274 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-15
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Heart rate, Oxygen saturation, Respiratory failure, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-19
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XARELTO; KLORAMFENIKOL VISKOES DAK; BETOLVEX [CYANOCOBALAMIN-TANNIN COMPLEX]; RISPERDAL; IMOZOP; ARAX; LAXOBERAL; SAPIMOL; ESOMEPRAZOL KRKA
Current Illness: Atrial fibrillation; Cerebral infarct; Chronic renal insufficiency; General physical health deterioration; Living in nursing home (there was a covid-19 outbreak among several residents and staff.); Renal cysts; Type 2 diabetes mellitus; Vascular dementia
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchospasm; Bypass surgery; Constipation; Esophageal acid reflux; Eye infection; Insomnia; Mania; Pain; Prostate cancer (Possibly Prostate cancer. Not diagnosed due to comorbidity); Vitamin B12 deficiency
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: Pulse rate; Result Unstructured Data: Test Result:76; Comments: 76 Unit not specified; Test Date: 202101; Test Name: Oxygen saturation; Test Result: 88 %; Test Date: 20210115; Test Name: Oxygen saturation; Test Result: 92 %; Test Date: 20210106; Test Name: COVID-19 virus test; Test Result: Negative ; Test Date: 20210113; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:unknown results; Comments: Test lost; Test Date: 20210118; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158632

Write-up: COVID-19/ COVID-19 virus test, positive; COVID-19/ COVID-19 virus test, positive; Respiratory insufficiency. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient.; This is as spontaneous report received from a contactable physician downloaded from the Medicine Agency (MA) Regulatory Authority-WEB. The regulatory authority report number is DK-DKMA-WBS-0032145. Safety Report Unique Identifier DK-DKMA-ADR 24693311. An 84-year-old male patient received first dose of bnt162b2 (COMIRNATY, Lot number: EJ6797, expiration date: 30Apr2021) intramuscular on 31Dec2020 at single dose for covid-19 immunisation. Medical history included bypass surgery from 2008 and not ongoing, conditions included pain, vitamin b12 deficiency, esophageal acid reflux, insomnia, eye infection, constipation, mania, bronchospasm, ongoing general physical health deterioration, ongoing type 2 diabetes mellitus, ongoing chronic renal insufficiency, renal cysts from 2014 and ongoing, vascular dementia from 2015 and ongoing, atrial fibrillation from 2018 and ongoing, cerebral infarct from 2019 and ongoing, undiagnosed prostate cancer and unknown if ongoing, possibly prostate cancer, not diagnosed due to comorbidity, the patient was ongoing living in nursing home, there was a covid-19 outbreak among several residents and staff. Concomitant medication included hydroxyzine hydrochloride (ARAX) from 14Dec2020 for pain, cyanocobalamin-tannin complex (BETOLVEX) from 25Jan2016 for vitamin B12 deficiency, esomeprazole magnesium (ESOMEPRAZOL KRKA) from 23Dec2020 for esophageal acid reflux, zopiclone (IMOZOP) from 15Sep2020 for insomnia, chloramphenicol (KLORAMFENIKOL VISKOES DAK) from 08Dec2020 for eye infection, sodium picosulfate (LAXOBERAL) from 15Sep2020 for constipation, risperidone (RISPERDAL) from 17Sep2020 for mania, ipratropium bromide, salbutamol sulfate (SAPIMOL) from 13Sep2020 for bronchospasm and xarelto (rivaroxaban) from 12Apr2018 as thrombosis prophylaxis. The patient previously received Influvectra (Influenza Type A and Influenza Type B vaccine, 4-valent) on 22Dec2020 for immunisation, pneumococcal vaccine polysacch 23v (PNEUMOVAX) on 19May2020 for immunisation. The patient experienced respiratory insufficiency, it is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient, in an 84 year old male patient vaccinated with bnt162b2. On 15Jan2021 the patient developed respiratory insufficiency, the patient was sweaty, did not react to voice or touch, the patient had apnoea, pain, increased fever and secretion and was treated palliatively with subcutaneous morphine. Spacer pressurised inhalation, prednisolone and furosemide (FURIX), but not with oxygen. On 18Jan2021 the patient was tested positive with COVID-19 and on 19Jan2021 the patient died. Respiratory insufficiency was reported by the physician as fatal. Reported causes of death: Death and of/with COVID-19. The patient underwent lab tests and procedures, which included test results COVID-19 virus test on 06Jan2021 as negative, COVID-19 virus test on 13Jan2021 as unknown result, test lost, COVID-19 virus test on 18Jan2021 as positive; Oxygen saturation on 15Jan2021 as 92%, Oxygen saturation on Jan2021, 88%, Pulse rate on Jan2021 as 76, unit not specified. Only ordinary inquest was performed post-mortem. No findings were reported. The patient died on 19Jan2021.An autopsy was not performed and the reported cause of death was Respiratory insufficiency and COVID-19. Causality from the reporter: it is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient.; Reported Cause(s) of Death: COVID-19/ COVID-19 virus test, positive; COVID-19/ COVID-19 virus test, positive; Respiratory insufficiency


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