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

Found 16,464 cases where Patient Died and Vaccination Date on/after '2021-01-01'

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Case Details

This is page 19 out of 1,647

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VAERS ID: 963235 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-04
Onset:2021-01-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-18
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Klonipin, Myrbetriq, Zoloft, Carafate, Isosorbide, Allopurinol, Colace, Calcium Carbonate, Synthroid, Famotidine, Metoprolol, Losartan, Tylenol
Current Illness:
Preexisting Conditions: HTN, Depression, Atherosclerotic heart disease, GERD, Hypothyroidism, Chronic renal failure stage 3, CHF
Allergies: Lisinopril
Diagnostic Lab Data: COVID test
CDC Split Type:

Write-up: Patient diagnosed with COVID on January 9, 2021 after being exposed to family member that was under quarantine in the same household. Admitted to the hospital and was discharged on January 14, 2021 with home hospice. Patient passed away on January 18, 2021


VAERS ID: 963269 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-04
Onset:2021-01-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-18
   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: Lisinopril, Januvia, Fosamax, Trazodone, Metoprolol, Colace Simvastatin, Levoxyl, Lantus, Zocor
Current Illness:
Preexisting Conditions: Type 2 Diabetes, HTN, DJD, Blindness bilateral, Glaucoma, Dyslipidemia, Diverticulosis, Osteoporosis, Memory loss, Chronic renal failure, CAD
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 01/18/2021


VAERS ID: 963388 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-01-05
Onset:2021-01-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-10
   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: Albuterol, Aspirin, Ativan, Ayr Saline Nasal, Biotene Dry mouth moisturizing spray, docusate sodium, Florajen 3, gabapentin, hydralazine HCL, Hydrocortisone acetate/LI, Isosource VHN 1.5 cal, ketoconazole, Lasix, lopressor, multivitamin, pl
Current Illness: No known illnesses at time of vaccination.
Preexisting Conditions: COPD, Aptyalism, upper respiratory tract infection due to Influenza, acute bronchitis, Pnuemonia, generalized anxiety disorder, impaired intestinal carbohydrate absorption, heart failure, GERD without esophagitis, long term current use of anticoagulant, transplanted skin present, history of UTISs, constipation, Periipheral vascular disease, chronic pain, history of amputation of lower limb above knee, sick sinus syndrome, candidiasis of skin, dysuria, Cerebrovasxular disease, cellulitis of toe of right foot, actinic keratosis, psoriasis, hyperlipidemia, intertrigo, dyspnea, dysphagia, and attention to gastrostomy, history of impacted cerumen in ears.
Allergies: Ceftriaxone sodium, Augmentin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient died unexpectedly 5 days after receiving vaccine (1/10/2021).


VAERS ID: 963610 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-14
Onset:2021-01-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-17
   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: Asprin 81mg Calcium Acetate 667mg Ensure Plus Eucerin Furosemide 80mg Glipizide 5mg Omeprazole 20mg Renvela 800mg Rifampin 300mg Sensipar Vitamin D3
Current Illness: TB DMII Hyperlipidemia GERD CKD Renal Failure
Preexisting Conditions: MII Hyperlipidemia GERD CKD Renal Failure
Allergies: NKDA
Diagnostic Lab Data: Rapid COVID swab done after death 1/18/21 1:04pm. The result was positive. Previous rapid done on 1/4/21 and was negative.
CDC Split Type: COVID-19 Vaccine

Write-up: Patient deceased on 01/17/2021


VAERS ID: 967743 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-19
Onset:2021-01-19
   Days after vaccination:0
Submitted: 2021-01-21
   Days after onset:2
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / -

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-19
   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:
Current Illness: n/A
Preexisting Conditions: Dementia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Possible seizer, unknown at this time, aprox 1hr and 20min after vac given. Passed away aprox 2hrs after vac.


VAERS ID: 964401 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-12
Onset:2021-01-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-16
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt died 4 days after vaccine, no known reaction to the vaccination


VAERS ID: 964617 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-01-08
Onset:2021-01-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   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: Oxycodone, ventolin, quetiapine, pantoprazole, metoprolol, lorazepam, haloperidol, senna, levetiracetam
Current Illness: Alzheimers, Covid, COPD, Mood disorder, convulsions, HTN, anxiety, DM, parkinson''s,
Preexisting Conditions: Alzheimers, Covid, COPD, Mood disorder, convulsions, HTN, anxiety, DM, parkinson''s,
Allergies: Codeine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Death, which I believe is unrelated to vaccination


VAERS ID: 964795 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-13
Onset:2021-01-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood culture negative, Computerised tomogram head normal, Diarrhoea, Mental status changes, Pyrexia, White blood cell count normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, Aspirin, Axitinib (Inlyta), Bisacodyl, Duloxetine, Ferrous Sulfate, Glucosamine Chondroitin, Norco, Tresiba, Lovastatin, Magnesium, Senna, Tamsulosin, Warfarin
Current Illness: Metastatic Renal Cell Carcinoma Diagnosed with COVID-19 on 12/7/2020, unknown severity of disease. Received first Pfizer SARS-COV-2 vaccine at the end of December
Preexisting Conditions: Insulin dependent Type 2 Diabetes, CKD3, atrial fibrillation, sick sinus syndrome s/p pacemaker on warfarin, hypertension, diastolic heart failure, gastric ulcers, emphysema
Allergies: Penicillin- Swelling of tongue and neck
Diagnostic Lab Data: 1/14/21 CT head unremarkable, blood culture no growth. Normal WBC 1/18/21 blood cultures no growth
CDC Split Type:

Write-up: Symptoms of fever (Tmax 102.9), diarrhea, and altered mental status started ~ 24 hours after vaccination. No evidence of septicemia with negative blood cultures Minimal improvement over 3 days, transferred to tertiary care center for MRI brain after which LP was recommended. However family declined as intubation would have been required and was not consistent with patient''s goals of care.


VAERS ID: 965564 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-01-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cardiac arrest Narrative:


VAERS ID: 965571 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-13
Onset:2021-01-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Dysarthria, Fatigue, Malaise, Memory impairment
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1/13/21 pt came into clinic for vaccine. Had difficulty remembering age. Called me Mon. 1/18/21 stating she was sick. When asked what her sx were, she stated fatigue. She was well the night of the shot, Thur. and Fri. but became tired on Sat. and Sun. I went through other sx with her such as h/a, fever, n/v, muscle aches, weakness and she said she experienced none of those. I questioned her about eating and drinking and she said she ate and drank water. She seemed fine so I told her to call her doctor if she was worse or the fatigue persisted or call 911. She agreed. Two staff from clinic called her Mon. and Tues, (1/18 and 1/19). On Tues. she may have had sl slurred speech. She was found deceased on


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