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From the 1/14/2022 release of VAERS data:

Found 669 cases where Patient Died and Vaccination Date from '2020-01-01' to '2020-12-31'

Government Disclaimer on use of this data



Case Details

This is page 28 out of 67

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VAERS ID: 1202967 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-03-20
Onset:2021-04-08
   Days after vaccination:384
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Exposure to SARS-CoV-2, Pulse absent, Respiratory arrest, SARS-CoV-2 test positive, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   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: Tested positive for COVD on 4/1
CDC Split Type:

Write-up: Death Narrative: Patient had Pfizer COVID vaccine dose #1 on 3/20/21. He called his provider on 3/30 to report known exposure to COVID that occurred on 3/27 and 3/28. On 4/1 he tested positive for COVID swabbed at the facility and sent to the main facility for processing. He was notified of positive result on 4/1 at 4pm. He was advised to quarantine and to call facility call center/triage should he develop any fever, shortness of breath, and other Covid-related symptoms. Provider received a phone call from PD on 4/8 notifying of patient unattended death. According to EMS report neighbors were aware of patients COVID positive status. No one had seen or heard from the patient in 3 days so they contacted PD for wellness check. Entry was forced into apartment and patient was found deceased, sitting on the couch. Not breathing ashen color. Pt has ringer and no Pulse. PMH: Quit tobacco 5-15 yrs ago Hyperlipidemia Hyperglycemia Obesity Allergic rhinitis, stable Hx AAA and Right ICA aneurysm, S/P Open repair in 2013 Patient had no prior history of COVID before 4/1 diagnosis. He was not having any symptoms between 4/1 when he tested positive and he did not call to report any symptoms between 4/1 diagnosis and death. There was no communication after 4/1 positive covid test. Patient was scheduled for a phone call with RN on 4/8 the date he was found deceased. Cause of death is not mentioned, but suspected to be due to COVID infection. There were no reported side effects to COVID Vaccine administration.


VAERS ID: 1228015 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-02-02
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Death
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-02
   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: Death Narrative: Patient was not previously Covid positive and did not have any predisposing factors(PMH, allergies, etc.) for experiencing an adverse drug event. The ADR did not occur at the time of the administration of the vaccine nor was there an ADR that occurred between the observation period and the date of death. Patient was admitted to hospital from 11/18/20-1/26/21 for Dx: generalized weakness. Previously admitted 10/21/20-11/17/20 for a pulmonary embolism. Patient did not last long after being discharged from short term rehab and passed away at home on 2/2/2021


VAERS ID: 1228016 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-02-17
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-17
   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: Death Narrative: Patient was not previously Covid positive and did not have any predisposing factors(PMH, allergies, etc.) for experiencing an adverse drug event. The ADR did not occur at the time of the administration of the vaccine nor was there and ADR that occurred between the observation period and the date of death. Patient was 92 and a resident at facility when he passed away. Patient has been LTC resident since 2/15/2019 and received hospice services prior to receiving first Pfizer vaccine dose. Patient receiving hospice care for terminal colon cancer.


VAERS ID: 1223867 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2020-12-29
Onset:2021-01-18
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Cardiac arrest, Carotid pulse abnormal, Death, Dysarthria, Facial paralysis, Pupil fixed, Respiratory arrest, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: Dementia with Behavior disturbance
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 1800, nursing staff reported patient had facial drooping and slurred speech. Patient vitals were stable. Symptoms resolved. 2/1/2021 Resident observed in the bedroom, unresponsive. No heartbeat or lung sounds upon auscultation. Pupils mid-dilated and fixated, no reaction to light. Carotid pulses were not palpable. Pronounced dead at 1422 by nurse practitioner.


VAERS ID: 1255612 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2020-12-18
Onset:2021-04-06
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart attack and death; This is a spontaneous report from a contactable Nurse. A 49-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: Ej1685) intramuscular in left arm on 18Dec2020 at 11:00 AM at single dose for COVID-19 immunisation. Medical history was none, no known allergies. No other concomitant medications in two weeks. No other vaccine in four weeks. The patient experienced heart attack at 05:30 pm on 06Apr2021 and the event caused patient death. No treatment for the event. Autopsy results was available. Autopsy remarks: heart attack. No COVID prior vaccination, no COVID tested post vaccination. The patient died on 06Apr2021. An autopsy was performed and the reported cause of death was heart attack.; Sender''s Comments: Myocardial infarction occurred 3 months and 19 days after BNT162B2 vaccine administration. The event is considered unrelated to suspect drug being rather an incidental occurrence. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Heart attack and death; Autopsy-determined Cause(s) of Death: Heart attack


VAERS ID: 1257426 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-30
Onset:2021-01-18
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cardiac arrest, Death, Product preparation error, Resuscitation
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), Medication errors (narrow)

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: Berberine Alpha Lipoic Acid Magnesium Taurate Vitamin D Zinc
Current Illness:
Preexisting Conditions: Cognitive decline that ceased and condition improved since meds were stopped in August 2019 Diabetes Type 2
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart stopped suddenly after 18 days probably due to presence of Potassium Chloride in the injection. Outcome DEATH within 2 hours thereof as medics unable to regain consciousness after CPR.


VAERS ID: 1261483 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2020-12-28
Onset:2021-01-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-13
   Days after onset: 42
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: VALTREX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Diagnosed with shingles; passed away suddenly; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DEATH (passed away suddenly) and HERPES ZOSTER (Diagnosed with shingles) in a 75-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included No adverse event (No reported medical history). Concomitant products included VALACICLOVIR HYDROCHLORIDE (VALTREX) for an unknown indication. On 28-Dec-2020 at 3:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jan-2021, the patient experienced HERPES ZOSTER (Diagnosed with shingles) (seriousness criterion hospitalization). The patient died on 13-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, HERPES ZOSTER (Diagnosed with shingles) outcome was unknown. Treatment included antiviral medication valtrex 1 mg. The action taken with mRNA-1273 with events was not applicable. Cause of death was unknown. Plans for an autopsy were not provided. This case concerns a 75-year-old, male patient, who experienced herpes zoster 5 days after and died 1 month 15 days after receiving the first dose of mRNA-1273. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The cause of death was not reported. It is unknown if an autopsy was performed. Most recent FOLLOW-UP information incorporated above includes: On 11-Apr-2021: Follow-up included fatal event.; Sender''s Comments: This case concerns a 75-year-old, male patient, who experienced herpes zoster 5 days after and died 1 month 15 days after receiving the first dose of mRNA-1273. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The cause of death was not reported. It is unknown if an autopsy was performed.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1276280 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2020-07-30
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (RABAVERT) / NOVARTIS VACCINES AND DIAGNOSTICS ARBA651B / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Animal bite, Autopsy, Blood immunoglobulin A decreased, Blood immunoglobulin G decreased, Blood immunoglobulin M increased, Death, Decreased appetite, Dysarthria, Dysphagia, Ear pain, Facial pain, Glomerular filtration rate, Hypoaesthesia, Infection, Laboratory test abnormal, Monoclonal gammopathy, Monoclonal immunoglobulin present, Musculoskeletal discomfort, Nausea, Night sweats, Rabies, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL TARTRATE; ASPIRIN /00002701/; GLUCOSAMINE CHONDROITIN /01430901/; SOTALOL; LOSARTAN; ATORVASTATIN; METFORMIN HYPERRAB S/D
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Benign prostatic hyperplasia; Chronic kidney disease stage 2 (grade 2/3); Chronic rhinitis (excl allergic); Coronary artery bypass graft; Coronary artery disease; Defibrillator/pacemaker insertion; Hyperlipidemia; Hypertension; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Name: GFR; Result Unstructured Data: ml/min
CDC Split Type: USBAVARIAN NORDIC A/SUSBN

Write-up: Rabies; Case reference number US-BN-2021-000045 is a spontaneous case report initially received on 02-Feb-2021, and concerns a *84-year-old* male patient. *The patient''s medical history included s/p ICD (internal cardiac defibrillator) procedure, s/p coronary artery bypass graft (CABG) x 3, hypertension associated with diabetes, hyperlipidemia associated with type 2 diabetes mellitus, benign prostatic hyperplasia with lower urinary tract symptoms, unspecified morphology, coronary artery disease due to lipid rich plaque, controlled type 2 diabetes mellitus with stage 2 chronic kidney disease, without long-term current use of insulin, chronic kidney disease (CKD) stage 2,*(grade 2/3)* GFR 60-89 ml/min, rhinitis, nonallergic, chronic.* *Family history included unspecified cardiovascular disease (father and sister), unspecified cancer (brother), colon cancer (sister), No family history of bleeding disorder/clotting disorder or anesthesia problems and no family history of any neurological disease, had heart attacks in both his mother and father.* *The patient''s concomitant medication details included metoprolol tartrate, Aspirin (acetylsalicylic acid), Glucosamine-Chondroit-Biofl-Mn (glucosamine sulfate/ chondroitin sulfate), sotalol, losartan, atorvastatin and metformin.* *On 26-Jul-2020*, the patient was bitten by a bat that was confirmed to be infected with rabies virus by the Direct Fluorescent Antibody test. Unknown if any wound care performed or other medications/vaccines given.* On 30-Jul-2020, four days after exposure, the patient received the first dose of *RabaVert* (Inactivated Rabies Virus Vaccine, Batch no. ARBA651B) at dose of 2.5 units in right deltoid for a bat bite from a known rabid bat. On the same day, the patient received *Hyperrab S/D (Immunoglobulin human anti-rabies) 1700 units in right hand around bite site and remaining in right thigh, then 1500 units (5ml of (300 unit/ml) Lot number: R2MFD00163 (Exp. 15Jun2021)) and 200 units (0.667 ml of (300 units/ml) Lot number: R2MBD00113 (Exp. 11May2021)).* On 02-Aug-2020, the patient received the second dose of *RabaVert* (Inactivated Rabies Virus Vaccine, Batch no. ARBA651B) at dose of 2.5 units in left deltoid for a bat bite from a known rabid bat. On 06-Aug-2020, the patient received the third dose of *RabaVert* (Inactivated Rabies Virus Vaccine, Batch no. ARBA651B) at dose of 2.5 units in right deltoid for a bat bite from a known rabid bat. On 13-Aug-2020, the patient received the fourth dose of *RabaVert* (Inactivated Rabies Virus Vaccine, Batch no. ARBA651A) at dose of 2.5 units in right deltoid for a bat bite from a known rabid bat. *Since the patient was not known to have an immunocompromising condition at the time of vaccination, in accordance with ACIP guidance, the patient did not receive a 5th vaccine dose and was not advised to undergo antibody titer evaluation.* On an unknown date, *either 06-Jan-2021 or possibly earlier 31-Dec-2020, approximately five months after bat bite, the patient developed symptoms of rabies that progressed over the course of 17 days, until the patient passed away. Signs and symptoms included right sided facial pain, nausea, vomiting, difficulty swallowing, bilateral shoulder discomfort, numbness of right arm and shoulders, ear pain, decreased appetite, slurred speech and night sweats.* *On 23-Jan-2021*, the patient passed away due to *laboratory-confirmed* rabies infection. *The clinicians did not consider the patient immunocompromised when PEP was administered. Laboratory results at the time of hospitalization indicate the patient might have had an undiagnosed underlying immunocompromising condition, however, during life the patient was not known to have an underlying immunocompromising condition. Laboratory findings include increased gamma monoclonal protein (m-spike), elevated IgM, decreased IgA, decreased IgG, no detectable anti-rabies virus IgM by IFA, and no detectable rabies virus neutralizing antibody titers by RFFIT.* *At the time of this report it was known that the formal report of autopsy was still pending.* The reporter assessed the event of ''rabies'' as serious due to fatal outcome and did not provide causality assessment. Additional information was received from Agency on 03-Feb-2021 included confirmation that the country of occurrence. All follow-up information is blended into the case narrative above, with the latest information presented between asterisks (*). Follow up information was received from Agency on 08-Feb-2021: Information included patient''s age. Additional information received from Agency on 08-Feb-2021 included updated batch numbers. Additional information received from Agency on 09-Feb-2021 included updated medical history, concomitant medication details, information about autopsy, date of death, confirmation of country of origin, clinical course of events, details of administered RIG (rabies immunoglobulin), bite details and reason for delay vaccination. Additional information received from Agency on 09-Feb-2021 included informations about family medical history. Additional information received from Agency on 11-Feb-2021 included informations about batch number (administered to patient''s wife). As per call with reporter dated 12-feb-2021, further tests will be conducted and provided upon consolidation as per reporter information disclosed. Additional information received from Agency on 22-Feb-2021 included brand name of the suspect product and updated narrative.; Reporter''s Comments: In this case report, an 84-year-old male patient had a fatal outcome due to Rabies breakthrough infection, 186 days after a confirmed rabid bat bite. Four days following the bite post exposure prophylaxis was initiated, including4 doses of RabAvert along with RIG. Patients'' laboratory reports for serum proteins revealed M-spike with increase in gamma monoclonal protein and his relevant concurrent conditions included diabetes and chronic renal failure. Considering presence of comorbidities in this elderly patient and laboratory reports which are suggestive of a previously unrecognized immunocompromising condition as contributory factors, as per current information available, the Agency assesses the case as not related to product. further post-mortem histopathologic tests are pending to confirm underlying immunosuppression.; Sender''s Comments: In this case report, an 84-year-old male patient had a fatal outcome due to Rabies breakthrough infection, 186 days after a confirmed rabid bat bite. Four days following the bite post exposure prophylaxis was initiated, including4 doses of RabAvert along with RIG. Patients'' laboratory reports for serum proteins revealed M-spike with increase in gamma monoclonal protein and his relevant concurrent conditions included diabetes and chronic renal failure. Considering presence of comorbidities in this elderly patient and laboratory reports which are suggestive of a previously unrecognized immunocompromising condition as contributory factors, as per current information available, the Agency assesses the case as not related to product. further post-mortem histopathologic tests are pending to confirm underlying immunosuppression.; Reported Cause(s) of Death: Rabies


VAERS ID: 1281673 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-28
Onset:2021-01-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cerebrovascular accident, Death
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-08
   Days after onset: 7
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: unknown
Current Illness: none
Preexisting Conditions: osteoporosis, eczema
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: stroke leading to death


VAERS ID: 1303474 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Georgia  
Vaccinated:2020-12-28
Onset:2021-02-15
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death. Date of death unknown


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