National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

Found 14,925 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 41 out of 150

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140   next


VAERS ID: 1300070 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-05-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bumetadine, Atorvastatin, Fluoxetine, Mirtazapine, Trazodone, Metoprolol, Omeprazole, Acetaminophen, Losartan, Rivaroxaban, Riboflavin, Benocaine, Albuterol, Budesonide, Cholecalciferol,
Current Illness: See Item 12
Preexisting Conditions: GERD, Anxiety, HTN, Hyperlipidemia, Pacemaker, A-Fib, Obesity, CHF, Chronic Lower Back Pain with Sciatica, Depression, Chronic Kidney Disease, Iron Deficiency Anemia.
Allergies: NKDA
Diagnostic Lab Data: See Medical record
CDC Split Type:

Write-up: Pt. arrived the hospital on 5/1/21 c/o SOB. Within a few hours, she went into cardiac arrest and was resuscitated. Pt. was placed on a Ventilator. She expired on 5/4/21.


VAERS ID: 1300291 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-02-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Neurological symptom
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   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: She was DNR and considered to have passed away peacefully in home. Presented with stroke like symptoms for several hours before passing away.
CDC Split Type:

Write-up: Passed away in home days after vaccine, was in perfect health as far as can be expected by 93 year old, before vaccine.


VAERS ID: 1301096 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-06
Onset:2021-05-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood lactic acid, Cardiac operation, Cerebral haemorrhage, Computerised tomogram abnormal, Coronary artery embolism, Hepatic vascular thrombosis, Intracardiac thrombus, Myocardial infarction, Pulmonary thrombosis, Renal vascular thrombosis, SARS-CoV-2 test negative, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Renovascular disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-08
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vancomycin
Current Illness: 3 weeks post op colostomy surgery
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data: Cat scan found embolisms on Friday 5/8/2021. Covid test was negative, lactic acid was 15.
CDC Split Type:

Write-up: 32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday.


VAERS ID: 1301355 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none per parents
Preexisting Conditions: Thyroidectomy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: She began having shortness of breath after getting her second shot. He parents found her dead in her bed this afternoon. No other known comorbidities.


VAERS ID: 1301797 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Death, Hepatic failure, Nausea, Renal failure, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-23
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Primary biliary cirrhosis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Primary biliary cirrhosis. On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown. The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021. No other treatment medication were reported. Company comment: Very limited information regarding this events has been provided at this time. However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.; Sender''s Comments: Very limited information regarding this events has been provided at this time. However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.; Reported Cause(s) of Death: unkown cause of death


VAERS ID: 1301919 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-29
Onset:2021-04-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   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:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Death; This case was received via FDA VAERS on 04-May-2021 and was forwarded to Moderna on 04-May-2021. This regulatory authority case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Death) in a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. No Medical History information was reported. On 29-Mar-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Death occurred on 01-Apr-2021 The patient died on 01-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Symptom Text : Death reported to Health department from Medical Examiner office, no further details provided Company comment:This is a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) who died 3 days after the second dose of vaccine. No Med history and no concomitant medication were provided. Very limited information has been reported at this time. Further information is not expected.; Sender''s Comments: This is a 76-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) who died 3 days after the second dose of vaccine. No Med hx and no conmeds were provided. Very limited information has been reported at this time. Further information is not expected.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1301965 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-04-27
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   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: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210505962

Write-up: DEATH; This spontaneous report received from a company representative concerned a 49 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2. s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, frequency 1 total, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 27-APR-2021, the patient died from unknown cause of death after 4 weeks of Johnson and Johnson vaccination. An autopsy was performed on an unspecified date and there was no sign of high blood pressure, heart disease, or diabetes to patient as per report. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0. 20210505962-covid-19 vaccine ad26.cov2.s -Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH; Autopsy-determined Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1301967 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Intracardiac thrombus
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506615

Write-up: BLOOD CLOT IN HEART; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on 2021 for prophylactic vaccination. The batch number was not reported and it has been requested. No concomitant medications were reported. On 2021, the patient died due to blood clot in heart. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0 20210506615-COVID-19 VACCINE AD26.COV2.S- blood clot in heart. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: BLOOD CLOT IN HEART


VAERS ID: 1302134 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Death
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: 2021-05-08
   Days after onset: 30
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had several ED visits within 6 weeks of receiving COVID vaccination. He first presented to the ED on 4/8/21, was admitted on 4/9/21 for 2 days. He was admitted again on 4/20/21 for 6 days. He presented to the ED on 5/8/21 with cardiac arrest and died.


VAERS ID: 1302209 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-12
Onset:2021-05-01
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cardiac failure acute, Condition aggravated, Death, Dyspnoea, Endotracheal intubation, Hypoxia, Intensive care, Intensive care unit acquired weakness, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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: 2021-05-05
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 41 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: pt is 82 yo wm with acute on chronic CHF, CAD, CKD, DM2, and AF. Presented to hospital with acute SOB/hypoxia. Was intubated and sent to another hospital and admitted to ICU. Gradually improved and was transferred to Rehab Hospital due to ICU myopathy. Acutely decompensated with respiratory failure on 5/1. transferred back to ICU in LR and tested positive for COVID via biofire pcr . of note his first pfizer dose was on 1/21 and the lot was EL3302. Patient died on 5/5/21
Allergies:
Diagnostic Lab Data: covid biofire pcr test
CDC Split Type:

Write-up: death from covid 3 months after completing series


VAERS ID: 1302213 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-16
Onset:2021-03-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-20
   Days after onset: 1
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: Short of breath, died March 20, 2021


VAERS ID: 1302239 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-14
Onset:2021-04-28
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Death, Dyspnoea, Incontinence, Posture abnormal
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-28
   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: Cetirizine 10 mg tablets, Citalopram 40 mg tablets, Diltiazem 30 mg tablets, Gabapentin 300 mg capsules, Simvastatin 10 mg tablets, and Topiramate 50 mg tablets.
Current Illness: None.
Preexisting Conditions: Idiopathic peripheral autonomic neuropathy, Depression, insomnia.
Allergies: Oxycodone-acetaminophen and Cymbalta.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival.


VAERS ID: 1302294 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-30
Onset:2021-04-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 031B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Failure to thrive, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Sepsis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Neonatal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Parkinson disease Hypertension Chronic kidney disease, stage III
Preexisting Conditions:
Allergies: No Known Allergies
Diagnostic Lab Data: COVID 19 positive
CDC Split Type:

Write-up: fever and generalized weakness bilateral pneumonia secondary to COVID-19 infection Failure to Thrive, Severe Sepsis antibiotics: Levaquin, ceftriaxone and Remdesivir, insulin: Humalog and respiratory therapy: O2


VAERS ID: 1302328 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-01-21
Onset:2021-01-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Laboratory test, Vaccination complication
SMQs:

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: ASPRIN D3 ZERALTO LISINOPRIL
Current Illness: NONE
Preexisting Conditions: A FIB
Allergies: NONE
Diagnostic Lab Data: A MILLION CK HOSPITAL
CDC Split Type:

Write-up: I COULDN"T WRITE DOWN WHAT WE WENT THROUGH . DOCTORS SAID THE VACCINE STIMULATE A CELL THAT MIGHT NEVER BE SEEN IF HE DID NOT HAVE VACCINE. HE WAS A VETERINARIAN UNTIL AFTER THE SECOND SHOT HEALTHY WALKING 2 MILES 3 TO 4 TIMES DAILY ETC ETC DID THE VACCINE SO WE COULD GO ON VACATION....ENTERED HOSPITAL AND WITH ALL THE DOCTORS SAYING HE WILL BE ALRIGHT IN A FEW DAYS OUR VACATION TURNED OUT TO BE A 15,000DOLLAR FUNERAL THEN DIED


VAERS ID: 1302383 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH COVID-19 / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Autopsy, Cardiac valve disease, Cardiomegaly, Death, Fatigue, Feeling abnormal, Injection site bruising, Product administered at inappropriate site, Respiratory arrest, Resuscitation, Snoring, Unresponsive to stimuli
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Drug abuse and dependence (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   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: No
Current Illness: Not known of
Preexisting Conditions: Not known of
Allergies: No known of
Diagnostic Lab Data: On May 4, office call me in the afternoon. They told me their autopsy indicated he had an enlarged heart and a defective valve.
CDC Split Type:

Write-up: He felt very bad the night he received the 2nd shot of Pfizer covid-19 vaccine on April 27. He even joked he probably would die that night. He also complained that despite his protest, the person who administered the shot insisted to inject on his shoulder joint. He developed a bigger-than-quarter-size bruise on his right inner arm the next day. He was feeling tired the following days. On May 4 around 3:30, I heard he was making loud noises. I came to his side immediately. At the time I thought he was making louder than usual snores. I nudged him gently but he didn''t respond. After about 15 seconds, the sound stopped, and he had no breath. I then called 911 within 10 seconds, tried to do CPR on him. It took EMS 6 minutes to arrive even though we live very close to a fire station in a well-accessed urban area. EMS worked on him for about 30 minutes before transported him to hospital. They continued to work on him for a while. He never regained breath.


VAERS ID: 1302428 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Apnoeic attack, Cyanosis, Death, Resuscitation, Unresponsive to stimuli, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient was last seen well at 3:30 PM. He was found unresponsive, face down in his own vomit, cyanotic, apneic by family. Patient was unable to be resusitated. He was pronounced dead at 6:51 PM.


VAERS ID: 1302438 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-22
Onset:2021-04-30
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0172 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-30
   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: lorazepam, furosemide, isosorbide mononitrate, carvedilol, buspirone, potassium chloride
Current Illness: Patient had been sick and in the hospital for a period of time prior to her vaccination. She had ''internal bleeding'' from an unknown source according to her husband. On May 3 patient''s husband called the pharmacy to report that patient had passed away on April 30. He did not give any reasons for her death or any symptoms prior to her passing. Patient was well known and like by our pharmacy staff.
Preexisting Conditions: Patient had anxiety, high blood pressure, heart conditions, and p/h of internal bleeding.
Allergies: no known allergies
Diagnostic Lab Data: not known to the staff
CDC Split Type:

Write-up: Patient received the first Pfizer immunization on 4-22-2021. She passed away on 4-30-2021. Her husband notified the pharmacy. Patient had been hospitalized for a period of time before the vaccination for ''bleeding internally'' due to an unknown cause.


VAERS ID: 1302490 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-12
Onset:2021-04-24
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, COVID-19, Cough, Death, Dyspnoea, Fatigue, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-10
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet,delayed release TAKE 1 TABLET BY MOUTH ONCE DAILY. 03/29/21 filled surescripts Asprin Ec Low Dose 81 mg tablet,delayed release Take 1 tablet(s) every day by oral route. 11/19/19 entered ciprofloxacin 500 mg tablet
Current Illness: Multiple chronic illnesses Type II diabetes mellitus uncontrolled - Onset: 11/19/2019 Mixed hyperlipidemia - Onset: 11/19/2019 Benign essential hypertension - Onset: 02/24/2020 History of aortic valve replacement - Onset: 02/24/2020 Permanent cardiac pacemaker - Onset: 02/24/2020
Preexisting Conditions: Type II diabetes mellitus uncontrolled - Onset: 11/19/2019 Mixed hyperlipidemia - Onset: 11/19/2019 Benign essential hypertension - Onset: 02/24/2020 History of aortic valve replacement - Onset: 02/24/2020 Permanent cardiac pacemaker - Onset: 02/24/2020
Allergies: NKDA
Diagnostic Lab Data: Would need records from medical center as well as other medical center.
CDC Split Type:

Write-up: On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021. This report is being made in regards to the claim by the CDC that "no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized." This patient was not only hospitalized but passed away.


VAERS ID: 1302513 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-01
Onset:2021-03-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Metformin, Nexium, Levothyroxine, Simvastan, Calcium 500+D, Vitamin B complex plus B12.
Current Illness: None
Preexisting Conditions: Diabetes, neuropathy.
Allergies: None
Diagnostic Lab Data: Emergency room attempt to necessitate. Medical examiner determined cause of death.
CDC Split Type:

Write-up: Death listed as a heart attack. No symptoms, but took an abnormally long nap just prior to the attack.


VAERS ID: 1302631 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-01-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute myocardial infarction, Blood loss anaemia, Craniocerebral injury, Death, Fall, Loss of personal independence in daily activities, Mobility decreased, Skin laceration, Subdural haematoma, Traumatic haematoma
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (narrow), Haemorrhagic central nervous system vascular conditions (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), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 100
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 86 year old male received the Covid shot on 1/20/21 and went to the ED on 1/23/21 and was admitted on 1/23/21 and again went to the ED and admitted on 4/4/21 and again to the ED on 4/26/21 with the diagnoses listed below and died on 5/4/21. D50.0 - Blood loss anemia I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC) N17.9 - AKI (acute kidney injury) (CMS/HCC) S09.90XA - Closed head injury, initial encounter W19.XXXA - Fall, initial encounter S01.01XA - Laceration of scalp, initial encounter S06.5X9A - Subdural hematoma (CMS/HCC) S06.5X9A - Traumatic subdural hematoma (CMS/HCC) Z74.09, Z78.9 - Impaired mobility and ADLs


VAERS ID: 1302667 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-04-08
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Death, End stage renal disease, Pancytopenia, Pleural effusion, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (narrow), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 82 year old female received the Covid shot on 3/31/21 and went to the ED on 4/8 /21 and again to the ED and admitted on 5/7/21 with the diagnoses listed below and died on 5/9/21. J90 - Pleural effusion, not elsewhere classified N18.6 - ESRD (end stage renal disease) D61.818 - Pancytopenia A41.9, R65.20 - Severe sepsis


VAERS ID: 1302705 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-05-05
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 49 year old female received the Covid shot on 4/6 /21 and went to the ED on 5/5 /21 with the following diagnoses listed below and died on 5/5/21.


VAERS ID: 1302712 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-05-05
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 70 year old female received the Covid shot on 4/9/21 and went to the ED on 5/5/21 died on 5/5/21.


VAERS ID: 1302793 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-18
Onset:2021-03-30
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-20
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes Cardiovascular disease Chronic Renal Disease High Blood pressure Former smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization and Death


VAERS ID: 1302844 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-06
Onset:2021-05-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Autopsy, Chest pain, Death, Dyspnoea, Lethargy
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine pamoate
Current Illness:
Preexisting Conditions: Hypertension, non-insulin dependent diabetes
Allergies: None
Diagnostic Lab Data: Autopsy on May 10, 2021. Results pending.
CDC Split Type:

Write-up: Lethargy began the day of vaccine and shortness of breath along with abdominal and chest pain followed the next day. Decedent was found deceased the next evening.


VAERS ID: 1302927 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-04
Onset:2021-05-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B12A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 UN / IM

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

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: hypertension, hyperlipidemia, hyperglycemia, tobacco use
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt contacted our officeat approx 12:30PM on 5/10/21 stating that she thought she was having a reaction to the second vaccine. We received a call from the Deputy Sheriff at approx 4:50 PM to inform us that this pt has passed away apox. 4 hours prior. COD: pending. We have not other information at this stime


VAERS ID: 1302958 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-10
Onset:2021-02-21
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-27
   Days after onset: 6
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: Chronic Lung Disease Hypertension Former Smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization and Death


VAERS ID: 1303031 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-05-01
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-01
   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:
CDC Split Type:

Write-up: This 68 year old black male received the Covid shot on 3/17/21 and died 5/21.


VAERS ID: 1303041 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-22
Onset:2021-04-28
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 77 year old male received the Covid shot on 2/22/21 and went to the ED and admitted on 4/28/21 with the diagnoses listed below and died on 5/5/21. cause of death unknown at time of report


VAERS ID: 1303069 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-05-06
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-06
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 75 year old female hospice patient received the Covid shot on 3/24/21 died on 5/6/21.


VAERS ID: 1303074 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest tube insertion, Death, Deep vein thrombosis, Lung neoplasm malignant, Pain in extremity, Pulmonary mass, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   Days after onset: 25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Anti-rejection medications status-post solid organ transplants
Current Illness: When went to hospital with concern for clots from vaccination, it was discovered that he had a lung nodule which was found to be cancerous.
Preexisting Conditions: Previous transplants of kidneys x 2, and pancreas. Broken ankle 2 years prior.
Allergies: Unkinown
Diagnostic Lab Data: Wife reported the event to the Coronavirus Hotline/Poison Center; she did not have his medical records from the hospital. Reported information on this from is from the wife.
CDC Split Type:

Write-up: 1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021 2 days after 2nd dose, he developed severe pain in both legs. He was taken to the hospital where clots were diagnosed in both legs and groin area. A previously undiagnosed lung nodule was found and he was given a cancer diagnosis. He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission. Over the following weeks, he had a permanent lung drain placed. He died on May 5th or 6th at home. No autopsy performed.


VAERS ID: 1303119 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-03
Onset:2021-02-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Aggression, Bedridden, Blood glucose increased, Condition aggravated, Confusional state, Crepitations, Death, Dementia, Diabetes mellitus, Fatigue, General physical condition abnormal, Head injury, Hypotension, Patient restraint, Posture abnormal, Repetitive speech, Salivary hypersecretion, Slow speech, Somnolence
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 88
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 34 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: See medical file.
Current Illness: Some memory loss; diabetes type 2; bipolar disorder.
Preexisting Conditions: Same as in item 11.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: The morning after Mom''s first dose of the Pfizer shot, Dad woke up and found Mom lying on the floor next to the bed. Mom said, "I can''t move my arm." Dad called paramedics who checked her. They said her vital signs were normal and left. On 2/9/21 in the morning my da awoke to see that Mom had large amounts of bubbly saliva pouring from her mouth onto her pillow. Dad called paramedics, who said this was a diabetic reaction. Mom had NEVER had anything happen like this before. Mom was very sleepy, could not be aroused, and made only gurgling noises. She was admitted to the hospital for care and therapy. She pulled her own IV out. Mom had to be restrained in the hospital and sedated, due to confusion and worsening dementia. By 2/18 when we spoke by phone mom''s speech was abnormally slow and very repetitive. "I''m very tired today" was spoken many times. In morning time mom was able to follow basic conversation. Not so later in the day. Mom came home from rehab on 2/26/21. She was able to walk steadily and independently at home after her therapy. After a week or so, Mom began hitting the in-home caregiver. Dad''s presence would calm her. In a short time Mom seemed not to know dad anymore, and would hit him and the caregiver when they helped her. She also pulled all covers off the bed and pulled clothes out of the closet, throwing them all over the room during the night. Mom was usually walking around the house during each night. On 4/16/21 Mom and dad were napping sitting up on the couch in the morning. Mom fell forward and hit her head on the hearth. Dad and caregiver gave first aid and called paramedics, who took her to the ER. Mom came home on 4/17/21. On 4/18/21 Mom pulled her catheter out in the early morning. In the afternoon Mom''s appearance was concerning, so Dad called paramedics. They said that Mom''s BP had dropped very low and took her to the ER. Mom was combative the next day in the hospital. Dr. adjusted her medications periodically to ensure that mom''s care would be manageable when she would eventually be sent home. Minimal therapy was done due to dementia. By 5/3/21 doctor said that Mom is bed bound and needing total care. Her blood sugar spiked high despite special diet. Staff waiting for insulin order from doctor. 5/4/21 Doctor called Dad to say that Mom had died during the night.


VAERS ID: 1303145 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-13
Onset:2021-04-30
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chronic obstructive pulmonary disease, Death, Fall, Femoral neck fracture, Fracture displacement, Head injury
SMQs:, Accidents and injuries (narrow), Osteoporosis/osteopenia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 98 year old female received the Covid shot on 2/13/21 and went to the ED and admitted on 4/30/21 with the diagnoses listed below and died on 5/9/21. J44.9 - COPD (chronic obstructive pulmonary disease) S72.002A - Left displaced femoral neck fracture W19.XXXA - Fall, initial encounter S09.90XA - Head injury, initial encounter


VAERS ID: 1303162 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-04-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 77 year old female received the Covid shot on 4/1/21 and went to the ED on 4/11/21 and admitted on 4/12/21 and again to the ED on 4/24/21 with the below listed diagnoses and died on 5/9/21. J18.9 - Pneumonia, unspecified organism


VAERS ID: 1303175 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-23
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Gastrointestinal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 60 year old black male received the Covid shot on 4/15/21 and went to the ED on 4/23/21 with the following diagnoses listed below and died on 4/27/21. K92.2 - Gastrointestinal hemorrhage, unspecified


VAERS ID: 1303190 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-04-11
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Death, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-03
   Days after onset: 22
Permanent Disability? No
Recovered? No
Office Visit? No
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: This 74 year old female received the Covid shot on 3/12/21 and went to the ED on 4/11/21 with the diagnoses listed below and died on 5/3/21. ABDOMINAL PAIN VOMITING


VAERS ID: 1303196 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-03-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, Anxiety, Asthenia, Blood gases abnormal, COVID-19, Chills, Condition aggravated, Constipation, Cough, Dyspnoea, Dyspnoea exertional, Dysuria, Magnetic resonance imaging abdominal normal, Malaise, Metabolic acidosis, Respiratory alkalosis, Urinary incontinence, Urinary retention
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (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 (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen 1000mg 3x/day, hydrochlorothiazide, levothyroxine
Current Illness: positive for covid 3/22/21, urinary incontinence/retention
Preexisting Conditions: hypertension, hypothyroidism, dyslipidemia, obesity, spinal stenosis, urinary retention with incontinence
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: per medical report from hospital- "presented to emergency room at outside facility secondary to worsening shortness of breath. The patient states that about 1 week ago she started feeling ill directly after receiving her first covid vaccine. the patient states her medical issues actually began approximately 2 months ago when she developed sudden onset positional urinary retention as well as urinary incontinence and constipation. She states that she thought maybe her known spinal stenosis had worsened causing her bladder dysfuntion.She states she tries to sit on a commode or a toilet and is unable to void however when lying flat she has to wear adult briefs as she has no control over her bladder at all. There is no p


VAERS ID: 1303208 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Chills, Death, Influenza like illness
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-03
   Days after onset: 26
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: PCN, Iodine, Tylenol
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Recieved obituray on patient. Called pt. ER contact and she stated that she was unaware how patient died. Pt. died at home but states that pt. had been having flu-like symptoms in bed with chills after vaccination. Pt. ER contact is unaware of pt. medical history or current medications. Pt. ER contact that pt. PCP was not us but another medical facility. Called funeral home and spoke to employee and she stated that the coroner cause of death listed was acute MI. Employee stated that she does not have a certified copy of death certificate at this time.


VAERS ID: 1303327 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-04
Onset:2021-03-13
   Days after vaccination:68
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 EL3302 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-23
   Days after onset: 9
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: Hospitalization and 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


VAERS ID: 1304120 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-16
Onset:2021-04-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bedridden, Confusional state, Decreased appetite, Fall, Gait inability, Hypophagia, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-10
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Systolic heart failure, CAD, HTN
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt c/o not feeling well and very weak right after receiving injection, and fell less than 3 hours later, would/ could not eat/drink or walk as usual, became confused and bedbound the same day of vaccination and appetite further deteriorated while weakness and confusion increased.


VAERS ID: 1304434 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Disability, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-30
   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: williams syndrome one functioning kidney faulty aorta asthma when young hyperlipidemia
Preexisting Conditions: williams syndrome one functioning kidney faulty aorta asthma when young hyperlipidemia
Allergies: unknown
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Patient found dead after receiving vaccine. At 11:44 on 3-30-2021 Medical Investigator was able to return call after leaving scene where there was no phone service. Police were on the scene requesting Medical Investigator Contact was made between Medical Investigator and member of the police force. Narrative was that the patient, who is handicap with considerable health issues which he was born with, and his parents had been to healthcare facility to receive COVID vaccination. Returning they had traveled in order to arrive at their residence. The decedent had asked to be dropped off close to parents home. The parents arrived at the residence and after waiting ten to fifteen minutes walked searching for the decedent. He was located unresponsive and 911 was initiated.


VAERS ID: 1304689 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-04-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-22
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness: High Blood Pressure, Diabetic
Preexisting Conditions: High Blood Pressure, Diabetic
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot


VAERS ID: 1304956 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210510772

Write-up: BLOOD CLOT; This spontaneous report received from a company representative concerned a 42 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number and expiry were unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, between three to ten days later after vaccination the patient died due to blood clots. It was unknown, whether autopsy was performed or not. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0;20210510772-covid-19 vaccine ad26.cov2.s-Thrombosis. This event(s) is considered unassessable. The event(s) has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: BLOOD CLOT


VAERS ID: 1305027 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: died after receiving the Moderna Covid-19 vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DEATH (died after receiving the Moderna Covid-19 vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. Death occurred on an unknown date The cause of death was not reported. It is unknown if an autopsy was performed. Not Provided Concomitant medications were not reported. No treatment information was provided. Action taken with mRNA-1273 in response to the drug was not applicable. Company comment: This is a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. died on an unknown date after the first dose of vaccine. No Medical History or Concomitant medications were reported. Very limited information has been reported at this time. Further information is not expected. This case was linked to US-MODERNATX, INC.-MOD-2021-012533, US-MODERNATX, INC.-MOD-2021-020196, MOD21-10588, MOD21-086364, MOD21-086368 (Linked Report).; Sender''s Comments: This is a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. died on an unknown date after the first dose of vaccine. No Medical History or Concomitant medications were reported. Very limited information has been reported at this time. Further information is not expected. US-MODERNATX, INC.-MOD-2021-012533: US-MODERNATX, INC.-MOD-2021-020196: MOD21-10588: MOD21-086364: MOD21-086368:; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1306318 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C2117 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Fatigue, Flushing, Pain in extremity, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-23
   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: Allergy NOS (unspecified allergy); Blindness (All blind in left eye); Feeding tube user; Neurofibromatosis, type 2 (acoustic neurofibromatosis) (Diagnosed at age 11, had tumor on nerves and all over body.); Walker user
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Went back to sleep and never woke up; Arm soreness; Feeling bad; very flushed/looked red; very tired/fatigue/nappy women taking a lot of naps; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Went back to sleep and never woke up) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C2117) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Neurofibromatosis, type 2 (acoustic neurofibromatosis) (Diagnosed at age 11, had tumor on nerves and all over body.), Blindness (All blind in left eye), Allergy NOS (unspecified allergy), Walker user and Feeding tube user. On 23-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced DEATH (Went back to sleep and never woke up) (seriousness criterion death), PAIN IN EXTREMITY (Arm soreness), VACCINATION COMPLICATION (Feeling bad), FLUSHING (very flushed/looked red) and FATIGUE (very tired/fatigue/nappy women taking a lot of naps). The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, PAIN IN EXTREMITY (Arm soreness), VACCINATION COMPLICATION (Feeling bad), FLUSHING (very flushed/looked red) and FATIGUE (very tired/fatigue/nappy women taking a lot of naps) outcome was unknown. The patient was on a feeding tube, lived independently but had a caretaker who came in every day. The patient had long list of medications for her conditions but concomitant medications were not provided by the reporter. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not applicable. Regarding the events of Pain in extremity, Fatigue, Flushing, Vaccination related malaise, based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, regarding the event of Death,Very limited information regarding this event has been provided at this time. Further information has been requested.; Sender''s Comments: Regarding the events of Pain in extremity, Fatigue, Flushing, Vaccination related malaise, based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, regarding the event of Death,Very limited information regarding this event has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1306337 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-18
Onset:2021-03-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Death
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), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-20
   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:
Current Illness:
Preexisting Conditions: morbid obesity, obstructive sleep apnea, HTN, Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient death certificate lists "natural" causes, with the Immediate Cause of Death of Cardiopulmonary Arrest.


VAERS ID: 1306733 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-26
Onset:2021-03-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DON''T KNOW / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood culture positive, Blood test, Computerised tomogram, Death, Echocardiogram, Electrocardiogram, Feeling abnormal, Injection site infection, Injection site pain, Intensive care, Magnetic resonance imaging, Mechanical ventilation, Mobility decreased, Pyrexia, Sepsis, Sleep disorder, Speech disorder, Tenderness, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 29
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 29 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Don''t know
Current Illness: None
Preexisting Conditions: Hypertension, kidney damage from autoimmune reaction, pacemaker
Allergies: None
Diagnostic Lab Data: Many blood tests, EKG, Echocardiogram, MRI''s, CAT scans, X-rays
CDC Split Type:

Write-up: On March 2, he woke up feeling bad and had a fever of 102.7. He took tylenol and liquids all day and the fever came down to around 100. The next morning he woke up complaining of excruciating pain in his left arm (site of the injection). He couldn''t stand to have anything touch it, couldn''t move it and couldn''t sleep because of the pain. The next morning he woke up very weak, wasn''t able to speak clearly, wasn''t making sense. He had a telemedicine appointment scheduled that morning for another matter. The doctor took one look at him and said we should have him evaluated asap. I took him to the emergency room at Hospital. They did some tests and said he was septic and immediately put him into the ICU. He was started on IV antibiotics while the blood cultures were growing out. It was determined that the bacteria was Strep G but they were unable to identify the source. He was put on a ventilator and an echo cardiogram was done. It was believed that the source of the infection was his pacemaker and I was told the pacemaker would have to be removed. They couldn''t do it at that hospital. He was transferred to another hospital. The doctors at that hospital determined the pacemaker was not the source. It was believed by some doctors that the source of infection was the injection site. The infection was cleared from his body and the ventilator was removed after 2 weeks. He lived another 2 weeks but never was able to recover. Until the day he was put on paliative care, he expressed pain in the arm where he had received the vaccination. He died at 5:30 a.m. on April 1, 2021.


VAERS ID: 1306869 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-19
Onset:2021-05-02
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute coronary syndrome, Acute respiratory distress syndrome, Alcohol use, COVID-19, Cardiac arrest, Central venous catheterisation, Death, Endotracheal intubation, Hypotension, Hypothermia, Intensive care, Life support, Multiple organ dysfunction syndrome, Pulseless electrical activity, SARS-CoV-2 test positive, Septic shock, Substance use, Supraventricular tachycardia, Toxicologic test abnormal, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-06
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: See prior Item number 18
CDC Split Type:

Write-up: Brief HPI and Hospital Course: 67 year old male with unknown past medical history was brought in by EMS as post-cardiac arrest. Patient was found on unresponsive on sidewalk, possible collapse. ACLS started by EMS, approx 10-15 minutes. Initial rhythm was junctional PEA. Was given 2 epi and intubated by EMS and had ROSC, Initial ROSC rhythm was SVT which slowed to 90s on its own. On arrival to ED, left femoral central line placed. Tox screen was positive for cocaine and ETOH. Was placed on ACS protocol for possible NSTEMI. Tested positive for COVID19 on admission. Patient required pressor support on admission. Hypothermia protocol was initiated. Patient was rewarmed per protocol, normothermic as of 5/5. Brief Narrative of Events leading to Patient''s Death: Patient remained normothermic with persistent septic shock, multi organ failure, ARDS secondary to COVID19. Multiple attempts to reach family members made by ICU team and palliative care team daily without answer. Patient made DNR by two-physician consent. Patient''s BP low despite maximum levophed support.


VAERS ID: 1306940 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-04
Onset:2021-02-10
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, 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: 2021-02-25
   Days after onset: 15
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:
Allergies:
Diagnostic Lab Data: PCR positive for COVID-19 on 02/10/2021
CDC Split Type:

Write-up: Hospitalized and died due to COVID-19 after being fully vaccinated.


VAERS ID: 1306986 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-07
Onset:2021-05-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient expired of probable aneurysm at Hospital on 5/10/2021


VAERS ID: 1307002 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-13
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, 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: 2021-05-04
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: No adverse reaction to vaccine. Pt positive for covid in april 2021. recieved 2 doses of pfizer vaccine (1/2021&2/2021)


VAERS ID: 1307384 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-11
Onset:2021-05-08
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 2 - / SYR

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

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: Schizophrenia, type 2 diabetes, Sleep Apnea, hypertension, Gerd, Hyperlipidemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was feeling fine the day before, went to sleep around midnight and passed away during the night while sleeping.


VAERS ID: 1307516 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-11
Onset:2021-04-17
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Death, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-26
   Days after onset: 9
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: lung disease, heart disease, renal disease
Allergies:
Diagnostic Lab Data: PCR positive for COVID-19 on 04/17/2021
CDC Split Type:

Write-up: Hospitalized and died due to COVID-19 after being fully vaccinated. From vital records: ACUTE RESPIRATORY FAILURE WITH HYPOXIA, PNEUMONIA DUE TO COVID-19


VAERS ID: 1307636 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-26
Onset:2021-05-08
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Diabetic ketoacidosis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chlorhexidine, Genteal Tears, Hibiclens, Fleet Enema, Digestive Enzymes, Bisacodyl Suppository, Amantadine, Gas-X, Duoneb, Phenytoin Suspension, Metoclopramide, Cimetidine, Furosemide, Pro-Stat, Valproic Acid Suspension, Potassium Chloride
Current Illness: Diabetic acidosis at the time admitted to the hospital on 5/8/21.
Preexisting Conditions: Pneumonia, Adrenal Hemorrhage, Anemia, Cerebral Edema, GERD, Head Trauma, Pneumothorax Tracheostomy, Rib Fracture, Seizures, Subdural Hematoma, UTI
Allergies: no known
Diagnostic Lab Data:
CDC Split Type:

Write-up: diabetic ketoacidosis on 5/8/21


VAERS ID: 1307637 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-15
Onset:2021-04-19
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, 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: 2021-05-01
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol 300 mg PO DAILY citalopram 20 mg PO DAILY albuterol sulfate [Ventolin HFA] 2 puff INHALATION Q4-6H PRN omeprazole 40 mg PO DAILY Entresto 0.5 tab PO DAILY cimetidine 200 mg PO DAILY furosemide 20 mg PO DAILY levothyroxine [
Current Illness:
Preexisting Conditions: CKDS3b (Baseline creatinine:1.8-2.2) Chronic Pancytopenia secondary to Obinutuzumab & Acalabrutinib therapy, worsened by IVF''s. Severe HFrEF secondary to non-ischemic cardiomyopathy most likely due to chemotherapy (EF:25% on 12.2020) Severe/Stage 3 COPD ( PFT on 10.2019: FEV1<70, FEV1/FVC:40) Chronic Hypoxic resp failure on 2L o2. Hx of NHL- Mantle cell Lymphoma (diagnosed in 2015) s/p CHOP-Rituxan currently on Obinutuzumab & Acalabrutinib
Allergies: penicillins, sulfa
Diagnostic Lab Data: SARS-COV-2 PCR detected on 4/7/2021 Confirmed variant of B.1.1.7 by health department
CDC Split Type:

Write-up: Patient received dose 1 on 2/12/2021 and dose 2 on 3/15/2021 from community pharmacy. Tested positive on 4/7/2021. Hospitalized for COVID on 4/19/2021. Discharged on 4/29/2021 to hospice. Passed away on 5/1/2021.


VAERS ID: 1307657 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-19
Onset:2021-04-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Completed suicide
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-23
   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: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death by suicide.


VAERS ID: 1307897 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-04
Onset:2021-05-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 5/4/2021 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Death, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-07
   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: Ibuprofen , Potassium Chloride
Current Illness:
Preexisting Conditions: Hypertension, smoker
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The decedent experience nausea, headache, and chest pain approximately 72 hours after receieving her second shot. She was found deceased later that day.


VAERS ID: 1308207 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-05-07
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Death, Dyspnoea, Resuscitation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Paxil 20mg and Trazodone 100mg
Current Illness: Depression / anxiety
Preexisting Conditions: unknown
Allergies: nka
Diagnostic Lab Data: unknown whether autopsy was obtained
CDC Split Type:

Write-up: #2 Moderna Vaccine given on 4/20/21 On 5/7/21 patient became SOB before syncope to cardiac arrest, event was witnessed and CPR started immediately. Patient expired 45 min later at Medical Center.


VAERS ID: 1308208 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-21
Onset:2021-05-05
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Death, Overdose
SMQs:, Drug abuse and dependence (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   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: Metformin 500mg 1 tab BIDPO Acetaminophen PRN Iron Tablets 1 tab POQD Protonix 40mg 1 tab POQD Cyclobenzaprine 5mg POTID Lisniporil 40mg 1 tab POQD
Current Illness:
Preexisting Conditions: Diabetic Neuropathy Diabetes Osteoarthritis of the knee ADHD Depression GERD Anemia Hyperlipidemia Hypertension
Allergies: Iodine Shellfish
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient died from methamphetamine/opiate overdose


VAERS ID: 1309191 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506934

Write-up: PASSED AWAY; This spontaneous report received from a consumer via social media concerned a female patient of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number and expiry were unknown) dose, start therapy date were not reported, 1 total, administered for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date (a couple of days after vaccination), the patient passed away. The cause of death was unknown. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death). This case, from the same reporter is linked to 20210508328.; Sender''s Comments: V0: 20210506934 -COVID-19 VACCINE AD26.COV2.S - Passed Away. This event is considered Unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1309418 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-02-09
Onset:2021-02-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Altered state of consciousness, Amnesia, Aphasia, Asthenia, Computerised tomogram head normal, Confusional state, Death, Fatigue, Iron deficiency anaemia, Laboratory test normal, Moaning, Renal failure, Unresponsive to stimuli, Urine analysis normal, Weight bearing difficulty
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-09
   Days after onset: 27
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol HFA PRN, Celecoxib, Citalopram, Fentanyl patch, Advair, Furosemide, Aldactone, Gabapentin, Norco PRN, Linzess, Montelukast, Primidone, Rabeprazole, Xarelto, Trazodone PRN.
Current Illness: Iron deficiency anemia
Preexisting Conditions: Chronic Respiratory Failure Osteoarthritis Lumbar Spondylesthesis Moderate Persistent Asthma General Anxiety Disorder
Allergies: Penicillin, Cefdinir, Patoprazole
Diagnostic Lab Data: ER Visit 2/11/2021: Mild iron deficiency anemia, negative CT of her head, negative UA, Stage 1 renal insufficiency. Labs repeated 2/15 are essentially unchanged.
CDC Split Type:

Write-up: Patient started 18-24 hours with loss of strength- inability to bear weight, and confusion with inability to communicate- both expressive and receptive, moaning and complete loss of awareness. The initial episode lasted approximately 4 hours. These episodes repeated for the next 3 days. She was taken to the Emergency Room by ambulance 3 days after the vaccine and a workup was completed. It was negative at the time of exam. She did have a mild anemia, but CT and laboratory work were otherwise negative. She had recovered strength and her memory. Later that evening she was again unresponsive except to painful stimuli and was like that over night. She was fatigued but was repulsive the next day. She never gained her full strength back. Over the next 4 weeks, she had progressively more of the periods of unresponsiveness and amnesia that stayed progressively longer and recovery was even less in-between the periods of unresponsiveness. She was placed on Hospice Care and succumbed on March 9, 2021, 1 month after her first vaccine.


VAERS ID: 1309628 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Virginia  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021498707

Write-up: died 3 weeks later after getting the vaccine.; This is a spontaneous report from a Pfizer-sponsored program. A contactable nurse reported that a patient (unknown age and gender) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number unknown) at single dose for COVID-19 immunisation on unknown date. Relevant history and concomitant drugs were unknown. The patient died 3 weeks later after getting the vaccine. It was unknown if autopsy was performed or not.; Sender''s Comments: The causal relationship between BNT162B2 and the fatal event cannot be excluded as the information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. 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: died 3 weeks later after getting the vaccine.


VAERS ID: 1309632 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, 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: 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021501749

Write-up: patient got infected with covid; patient got infected with covid; This is spontaneous report from a non-contactable consumer. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified dates (Batch/Lot number was not reported) at 1st dose, single and 2nd dose, single for covid-19 immunization. The patient''s medical history was not reported. There were no concomitant medications. While visiting abroad, patient got infected with covid and died on an unspecified date. Apparently, the patient received two Pfizer vaccines shots prior to his travel. It was unknown if an autopsy was performed. No follow-up attempts are possible, information about batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: patient got infected with covid


VAERS ID: 1309766 (history)  
Form: Version 2.0  
Age: 100.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-20
Onset:2021-01-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Haematemesis, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: metoprolol
Current Illness: AFib
Preexisting Conditions: HTN, NPH, Recovered COVID
Allergies: Fosamax, Novacaine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. developed emesis, vomiting blood afternoon after covid vaccine. She died within a few minutes. Resuscitation not attempted due to DNR status. Had recovered from covid months before.


VAERS ID: 1310067 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-18
   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: Insulin, heart medication (A-Fib), High Blood pressure med, Warfarin, anti anxiety medication, Specific meds upon request
Current Illness: Diabetes, A-Fib, High Blood Pressure, Depression, Anxiety, more upon request.
Preexisting Conditions: Diabetes, A-Fib, High Blood Pressure, Depression, Anxiety, more upon request.
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Death - Within 24 hours of receiving the vaccine the patient died.


VAERS ID: 1310163 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-04-18
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN3302 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-18
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died at nursing home facility. Patient had COVID back in 09/2020.


VAERS ID: 1310174 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-24
Onset:2021-05-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 2
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 on 2 May 2021


VAERS ID: 1310197 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-04-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-24
   Days after onset: 22
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 4/2/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Patient presented to the ED on 4/9/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. He also presented to the ED on 4/21/21. He died on 4/24/21.


VAERS ID: 1310308 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-03
Onset:2021-04-15
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, 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: 2021-04-27
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized on 4/15/2021 after being fully vaccinated. Tested positive on 4/19/2021. Patient died on 4/27/2021.


VAERS ID: 1310359 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-18
Onset:2021-05-12
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Exposure to SARS-CoV-2, 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: 0000-00-00
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient had covid shot on 3/18/21 then had known exposure on 04/06/21, tested positive for covid on 4/8/21, was admitted on 4/9/21, then died on 4/27/21. there is no indication the vaccination had anything to do with her death, but wanted to report.


VAERS ID: 1310493 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Hallucination, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-18
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CYMBALTA, ALBULTEROL HFA INHALER, TRELLEGY ELLIPTA
Current Illness: NO; CHRONIC HEALTH CONDITIONS - HOME HOSPICE CARE, STAGE 5 CHRONIC KIDNEY DISEASE, STAGE 4 COPD (O2 DEPENDENT)
Preexisting Conditions: UNDER HOME HOSPICE CARE, STAGE 5 CHRONIC KIDNEY DISEASE, STAGE 4 COPD (O2 DEPENDENT)
Allergies: NO KNOWN FOOD OR DRUG ALLERGY
Diagnostic Lab Data: No
CDC Split Type:

Write-up: The son came on 05/06 to receive the 2nd dose of Pfizer vaccine and informed us that his mother passed away on 04/18 after 3 days of post vaccination. A home hospice patient with Stage 5 Chronic kidney disease and Stage 4 COPD (Oxygen dependent) came in on 04/15 around 4:30 pm to receive a first dose of Pfizer. After 15 mandatory waiting in the pharmacy, she went home. Around 5:00 pm, patient told her son that she is feeling nauseated. Hospice nurse was contacted. On 4/16, patient experienced hallucination. She told her son that her fingers were disappeared. Hospice nurse was contacted. Please note that vaccine adverse event is not clearly related to vaccine, since patient was on hospice, stage 5 CKD and stage 4 COPD.


VAERS ID: 1310522 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-05
Onset:2021-05-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature increased, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Trazodone, Metformin, Gabapentin, Potassium, Duoneb
Current Illness: Acute on Chronic Heart Failure
Preexisting Conditions: Stage 4 Heart failure, T2DM
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At time of vaccination, patient had a temperature of 98.2 degrees Farenheit. Less than 24 hours later patient caregiver reports temperature of 102 degrees Farenheit. Monday morning, was notified that patient''s spouse found the patient unresponsive during the day after complaining about stomach pains on Sunday 5/9/2021.


VAERS ID: 1310557 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-04
Onset:2021-03-19
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 UN / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Death, Vital functions abnormal
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), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   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: Lisinopril 10mg, Prilosec 20 mg, Fosamax 35 mg, Aricept 10 mg, Montelukast, Xarelto 20 mg, Spironolactone 25 mg, Klonopin, Alendonate 25, Atorvastatin 20 mg, Seroquel, Namenda and Calcio 240 mg.
Current Illness: Unknown.
Preexisting Conditions: Arterial fibrational, Gastritis, Alzheimer, Hypertension, insomnia, osteoporosis and mayor depression.
Allergies: Unknown.
Diagnostic Lab Data: Unknown.
CDC Split Type:

Write-up: Cardio respiratory arrest. During rounds, patient was found without vital signs


VAERS ID: 1310622 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-06
Onset:2021-04-26
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A17691231 / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Death, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   Days after onset: 1
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: None
Preexisting Conditions: None known
Allergies: Unknown
Diagnostic Lab Data: Will need to request.
CDC Split Type:

Write-up: Developed symptoms around 4/25, presented to ED with complaints of chest pain and something being stuck in his throat. Subsequently died on 4/27.


VAERS ID: 1310651 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-02
Onset:2021-04-13
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-06
   Days after onset: 23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 23 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: alirocumab 75 mcg/ml, 1 ml q14 days, apixaban 2.5 mg po BID, aspirin 81 mg po daily, atorvastatin 80 mg po daily, calcium, estradiol vaginal cream, ferrous sulfate 325 mg po daily, fluoxetine 40 mg po daily, gemfibrozil 600 mg po BID, levo
Current Illness: - EColi UTI - New Praluent prescription
Preexisting Conditions: - cardiac transplantation secondary to viral myocarditis in 1998 - Chronic immunosuppression - CAD with prior inferior MI in 2/2019, status post DES x4, normal LVEF by echo 8/2018, she had a nuclear stress test in 6/2020 showing no evidence for myocardial ischemia - HTN - CKD - History of PE on chronic anticoagulation with Eliquis - Hypothyroid - Osteoarthritis of both hips - Gout - History of esophagitis, gastric ulcer, CDiff colitis and rectal cancer, s/p resection 2010
Allergies: carisoprodol - rash, adhesive tape, lisinopril - cough
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Moderna vaccine 3/2/2021 0.5 ml LD IM Lot: 029L20A and Moderna vaccine 3/30/2021 0.5 ml LD IM Lot: 019B21A. The patient was exposed to an infected person with Covid about 1 week after her second vaccine. She was admitted to the ICU with severe covid on 4/13/21. She was eventually transitioned to comfort care and died on 5/6/2021.


VAERS ID: 1310681 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-01-11
Onset:2021-02-08
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / UNK UN / IM

Administered by: Senior Living       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: 2021-02-13
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol 25mg, Simvastatin 20mg, Eliquis 5mg , Neurontin 800mg, Synthroid 50mg, Lisinopril 2.5mg, Tamsulosin 0.4mg, Multi-vitamins.
Current Illness: Unknown.
Preexisting Conditions: Cardiac problems (hypertension, calcified heart at 80%,
Allergies: Unknown.
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Cardiac arrest.


VAERS ID: 1310729 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-24
Onset:2021-04-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SC

Administered by: Private       Purchased by: ?
Symptoms: Death, Intensive care, Mechanical ventilation, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Coumadin
Current Illness:
Preexisting Conditions: Mechanical heart valves and on Coumadin.
Allergies:
Diagnostic Lab Data: To many to say here
CDC Split Type:

Write-up: Patient stopped breathing five days after the vaccine (5/29/21) He was taken to Hospital by paramedics and was put on ventilator in Intensive Care. They took him off the ventilator and he died 6 days after (5/5/21).


VAERS ID: 1310799 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-01-26
Onset:2021-05-02
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H20A / UNK UN / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / UNK UN / UN

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Respiratory arrest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-02
   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: Alzheimer and diabetes.
Allergies: Unknown.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Died of respiratory arrest.


VAERS ID: 1310855 (history)  
Form: Version 2.0  
Age: 100.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-01-02
Onset:2021-03-01
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / UNK UN / UN

Administered by: Senior Living       Purchased by: ?
Symptoms: Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-26
   Days after onset: 55
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasix, Carbidopa, Simvastatin, Atenolol, Folic Acid, Vitamin D, Protonic.
Current Illness: Unknown.
Preexisting Conditions: COPD, HBP
Allergies: Unknown.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Pneumonia.


VAERS ID: 1310861 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-09
Onset:2021-05-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Death
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: 2021-05-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
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, Death


VAERS ID: 1311143 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / IM

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

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: 05/07/2021- Health Department received notification that the patient was deceased. Wife notified Health Department to change phone number on file. Health Department was not given any information of cause of death. NOTE: It is unknown by Health Department if the cause of death had any relation to the vaccination or not.


VAERS ID: 1311196 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-08
Onset:2021-02-26
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Adenovirus test, Arterial catheterisation, Blood gases abnormal, Bordetella test negative, COVID-19, COVID-19 pneumonia, Central venous catheterisation, Chills, Cough, Death, Endotracheal intubation, Enterovirus test negative, Essential hypertension, Fatigue, Headache, Human metapneumovirus test, Human rhinovirus test, Hypercapnia, Hypercholesterolaemia, Hypotension, Hypoxia, Influenza A virus test negative, Influenza B virus test, Intensive care, Mechanical ventilation, Mycoplasma test negative, Oxygen saturation decreased, Pyrexia, Respiratory syncytial virus test negative, Respiratory syncytial virus test positive, SARS-CoV-2 test positive, Septic shock, Vitamin B12 deficiency
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Dyslipidaemia (narrow), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (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 (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-30
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 24 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet atorvastatin (LIPITOR) 20 mg tablet calcium polycarbophil (FIBERCON) 625 mg tablet cyanocobalamin 1,000 mcg tablet lisinopriL (ZESTRIL) 20 mg tablet potassium citrate (UROCIT-K) 10 mEq (1,080 mg) CR tablet
Current Illness:
Preexisting Conditions: Respiratory Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia (CMS/HCC) Circulatory Essential hypertension Digestive Diverticulosis of colon Tubular adenoma of colon Vitamin B12 deficiency Genitourinary Enlarged prostate without lower urinary tract symptoms (luts) Nephrolithiasis Musculoskeletal Alopecia Basal cell carcinoma of skin Endocrine/Metabolic Hypercholesterolemia Hyperglycemia Infectious/Inflammatory Septic shock (CMS/HCC)
Allergies: Propofol
Diagnostic Lab Data: Pneumonia due to COVID-19 virus 3/6/2021 - Present Older Results (important suggestion) These results were collected or performed more than 30 days ago. Updated Procedure 03/07/21 1354 Respiratory virus detection panel Collected: 03/07/21 1228 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Synctial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 03/06/21 1804 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 03/06/21 1604 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical ED to Hosp-Admission Discharged 3/6/2021 - 3/30/2021 (24 days) Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary Inpatient Discharge Summary BRIEF OVERVIEW Admission Date: 3/6/2021 Discharge Date: 3/30/2021 Discharge Diagnosis Hospital Problems POA * (Principal) Pneumonia due to COVID-19 virus Yes Hypercholesterolemia Yes Vitamin B12 deficiency Yes Essential hypertension Yes Septic shock (CMS/HCC) Yes Acute respiratory failure with hypoxia (CMS/HCC) Yes DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Community acquired pneumonia [J18.9] Pneumonia due to COVID-19 virus [U07.1, J12.82] Hospital Course Patient is a 78 y.o. male who initially presented to the emergency department on 3/6 due to fevers, chills, and hypoxia. In the emergency department he was tested positive for Covid and was admitted to the medical service. He was on the floor on high flow nasal cannula and self proning for several days. However, oxygenation status continued to worsen so he was sent to the intensive care unit. He was ultimately intubated on 3/15 and has been unable to be weaned from ventilator support. Because of patient''s worsening respiratory status palliative care was consulted to aid the family and decision making. The ABG showed worsening hypoxia and hypercarbia.. Shortly after that the patient was noted to be increasingly Hypotensive. At this timee patient''s wife was informed that his clinical status was looking worse and that the patient may not survive until the planned Palliative Care Discussion tomorrow morning. She planned to return to the hospital with her daughter. Informed the patient''s wife that his status was quite tenuous and that he may not survive until their arrival. She expressed understanding. Patient passed away this afternoon, time of death 1552. Operative Procedures Performed None Physical Exam at Discharge Heart Rate: 91 Resp: (!) 33 BP: 102/63 Temperature: 36.2 ?C (97.2 ?F) Weight: 94.8 kg (208 lb 15.9 oz) Condition at Discharge Discharge Condition: Deceased Other Notes All notes Procedures Central Line Insertion 3/15/2021 Arterial Line Insertion 3/15/2021 Anesthesia Record 03/15/21 INTUBATION - ANESTHESIA Procedure 78 y.o. Age 1.65 m (5'' 4.96") Height 94.8 kg (208 lb 15.9 oz) Weight 34.82 BMI Intraprocedure Grid/Graph Anesthesia Timeline Intra-op Flowsheet Data 03/15/20210227022802290230Totals(mg)etomidate (AM...14 mg(mg)succinylcholi...100 mg14100 Preprocedure Note No note exists Postprocedure Note No note exists Encounter Notes All notes Expand All Collapse All Anesthesia Procedure Notes (1) 3/15/2021 2:51 AM Airway from Horning
CDC Split Type:

Write-up: FEVER COUGH FATIGUE HEADACHES


VAERS ID: 1311276 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-09
Onset:2021-04-14
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Condition aggravated, Death, Endotracheal intubation, Extubation, Facial pain, Fall, Hypoxia, Intensive care, Jaw fracture, Oxygen therapy, Respiratory failure, SARS-CoV-2 test positive, Skin laceration
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-22
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: al mag hydroxide-simethicone-diphenhydramine-lidocaine (STOMATITIS) amLODIPine (NORVASC) 10 mg tablet chlorhexidine (PERIDEX) 0.12 % solution famotidine (PEPCID) 20 mg tablet(Expired) furosemide (LASIX) 40 mg tablet(Expired) omega-3 acid et
Current Illness: Cytomegalovirus (CMV) viremia
Preexisting Conditions: Respiratory Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia (CMS/HCC) Circulatory Demand ischemia (CMS/HCC) Essential hypertension Left femoral vein DVT (CMS/HCC) Digestive Esophageal reflux Malnutrition (CMS/HCC) Genitourinary Acute kidney injury (CMS/HCC) Glomerulonephritis, IgA Musculoskeletal Osteopenia Basal cell carcinoma of skin Intrinsic eczema Maxillary fracture (CMS/HCC) Endocrine/Metabolic Dyslipidemia Impaired fasting glucose Lactic acidosis Hypoalbuminemia Hyponatremia Infectious/Inflammatory Septic shock (CMS/HCC) Cytomegalovirus (CMV) viremia (CMS/HCC) Immune Severe sepsis (CMS/HCC) Immunosuppression due to drug therapy Other Squamous cell carcinoma Decreased GFR Aphthous ulceration Elevated LFTs Hypothermia
Allergies: NKA
Diagnostic Lab Data: Ordered Respiratory Therapy communication Initiate Epoprostenol Continuous Inhalation Daily 0800, Status: Canceled 04/22/21 0548 RT FLOLAN Assessment Q2H SCH Every 2 hours scheduled (odd hours), Status: Canceled 04/22/21 0548 Respiratory Therapy communication Initiate Epoprostenol Continuous Inhalation Once, Status: Canceled 04/22/21 0548 Transthoracic echo (TTE) complete Once, Status: Canceled 04/22/21 0023 RT FLOLAN Assessment Q2H SCH Every 2 hours scheduled (odd hours), Status: Canceled 04/21/21 2013 ETCO2 Mechanical Vent Daily 0800 Daily 0800, Status: Canceled 04/21/21 2058 Vent Settings (Trauma/Non-Trauma) Continuous (tasks Q4H), Status: Canceled 04/21/21 2058 Respiratory Therapy communication RT to discontinue ventilator bundle when patient extubated. Bronchodilators to continue as needed. Once, Status: Canceled 04/21/21 2058 Extubate patient - RT Once RT may extubate per protocol. Once, Status: Canceled Comments: RT may extubate per protocol. 04/21/21 2058 SBT Screen (Trauma/Non-Trauma) Per unit protocol Per unit protocol 04/21/21 2058 SBT (Trauma/Non-Trauma) Once If SBT (wean) screening criteria are met, perform a RR/VT. If RR/VT is less then 105, place patient on breathing trial using PSV of +5 to +7 cm H2O for 1 to 2 hours. At the end of the 1 to 2 hours perform another RR/VT... Once Comments: If SBT (wean) screening criter... 04/21/21 2058 Central Line Insertion Once Comments: This order was created via pro... 04/21/21 2039 Cardioversion - Electrical Once, Status: Canceled Comments: This order was created via pro... 04/21/21 2038 Respiratory Therapy communication During Proning, RT to adjust ventilator settings aggressively to goal Until discontinued, Status: Canceled Comments: During Proning, RT to adjust v... 04/21/21 2005 Respiratory Therapy communication Wean PEEP and FIO2 as tolerated when patient is supine if patient tolerates lighter sedation (RASS -2 to -3) and oxygenation goals are met. Until discontinued, Status: Canceled 04/21/21 2005 Moderate Sedation Once, Status: Canceled 04/21/21 1447 Oxygen therapy - High Flow Nasal Cannula (HFNC); Titrate Continuous (tasks Q4H), Status: Canceled 04/21/21 1010 CPAP - Acute respiratory failure Continuous (tasks Q4H) Continuous (tasks Q4H), Status: Canceled 04/20/21 1352 Wound care - Xeroform dressing, Exudry and rolled gauze to skin tears arms and legs daily. Daily 0900, Status: Canceled Comments: Xeroform dressing, Exudry and ... 04/15/21 1216 Wound care - Skin prep to heels daily and leave open to air Daily 0900, Status: Canceled Comments: Skin prep to heels daily and l... 04/15/21 1216 Airway Expansion & Secretion Clearance Protocol QID (daytime) Oscillatory PEP (OPEP) 4 times daily (daytime), Status: Canceled 04/14/21 1620 Oxygen therapy - High Flow Nasal Cannula (HFNC); 90% Continuous Comments: With surgical mask on patient 04/14/21 1620 Oxygen therapy - 90% As needed, Status: Canceled 04/14/21 1620 Change dressing Once on the morning after the procedure Once, Status: Canceled Comments: Once on the morning after the ...
CDC Split Type:

Write-up: Pneumonia due to COVID-19 virus ED to Hosp-Admission Discharged 4/14/2021 - 4/22/2021 (8 days) Last attending ? Treatment team Maxillary fracture Principal problem Final Summary for Deceased Patient Admission Date: 4/14/2021 Discharge Date: 4/22/2021 Final Diagnosis Principal Problem: Maxillary fracture (CMS/HCC) Active Problems: Pneumonia due to COVID-19 virus Demand ischemia (CMS/HCC) Dyslipidemia Essential hypertension Acute kidney injury (CMS/HCC) Glomerulonephritis, IgA Lactic acidosis Septic shock (CMS/HCC) Cytomegalovirus (CMV) viremia (CMS/HCC) Acute respiratory failure with hypoxia (CMS/HCC) Left femoral vein DVT (CMS/HCC) Malnutrition (CMS/HCC) Hypothermia DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Hypoxia [R09.02] Acute respiratory failure with hypoxia (CMS/HCC) [J96.01] Fall, initial encounter [W19.XXXA] COVID-19 [U07.1] COVID-19 virus infection [U07.1] Hospital Course Patient is a 72-year-old female with past medical history of hypertension, hyperlipidemia, recent hospitalization due to CMV viremia and an AKI and myelosuppression. Who presented to the emergency room after a fall in her house on 4/14. She had significant face pain and was hypoxic with an O2 saturation of 68% on room air on presentation. She was then found to be Covid positive. Initially admitted to the medical floor however required increasing amounts of oxygen and was ultimately transferred to the ICU on 4/16. She was maintained on nonrebreather oxygen until the evening of 4/21 when she was intubated and increasing vasopressor requirements. Given her worsening condition, her husband elected to palliatively extubate and pursue comfort care. Time of death was 10:02 AM on 4/22/2021. Disposition of the body: morgue


VAERS ID: 1311327 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident
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: 2021-05-20
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I63.9 - Acute CVA (cerebrovascular accident)


VAERS ID: 1311363 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-11
Onset:2021-05-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Death
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-12
   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:
CDC Split Type:

Write-up: Developed a cough after an unknown amount of time. Ultimately died on 5/12/21 at 1631 hours.


VAERS ID: 1311665 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-02
Onset:2021-05-07
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER873307/21 / 2 RA / IM

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: 2021-05-07
   Days after onset: 0
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: Antacids, vitamins, aspirin daily
Current Illness: None
Preexisting Conditions: Diverticulitis
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Subject suffered a massive heart attack while mowing the law . May be attributable to the Covid vaccine as the subject had been to the cardiologist prior to both vaccine and EKG and Stress test were perfectly normal


VAERS ID: 1311693 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-05
Onset:2021-05-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Agitation, Death, Dyspnoea, Hallucination
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-11
   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: none
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient was giventhe Janseen covid vaccine on 5/5. Apparently the patient 6 days later was reportedly aggitated had hallucinations and trouble breathing. The patient proceeded to lay down to rest. The patient never awoke.


VAERS ID: 1311975 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-11
Onset:2021-02-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Brain scan abnormal, Cerebral haemorrhage, Condition aggravated, General physical health deterioration, Headache, Hydrocephalus, Intracranial mass, Metastases to central nervous system, Ventriculo-peritoneal shunt
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-11
   Days after onset: 56
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Lung cancer
Preexisting Conditions: Lung cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After my father received the second COVID vaccination he started complaining of headaches. He had lung cancer, but he was in good condition. Within weeks his health deteriorated and when we bought him for a scan the beginning of March he had two small brain bleeds. The cancer had spread to the brain and he had a mass. They put a shunt in on March 18th because they said he had fluid, and this was the only treatment. Ten days later he was back in the hospital and after a week we had to take him home on hospice. I think the vaccine could of escalated his cancer this rapidly. Especially because he had two brain bleeds.


VAERS ID: 1312036 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-10
Onset:2021-05-08
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-08
   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: Tricor, xarelto, toprol
Current Illness: Afib
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death


VAERS ID: 1312219 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Dyspnoea, Fatigue, Malaise, Myocardial infarction
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-07
   Days after onset: 2
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: DIABETES HIGH BLOOD PRESSURE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well. Two days after getting the vaccine, he had trouble breathing, an ambulance was called and he was pronounced deceased hours later. He had a heart attack.


VAERS ID: 1312456 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04613212 / 7+ LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autopsy, Death, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Body was taken to Hospital for autopsy.
CDC Split Type:

Write-up: Death. While driving patient passed out and was found by County Sheriffs Office. EMT was called and could not save patient. M.E. Declared patient dead at 7:20 PM on May 4, 2021


VAERS ID: 1312481 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001CZ1A / UNK UN / IM

Administered by: Military       Purchased by: ?
Symptoms: Acute coronary syndrome, Death, Malaise
SMQs:, Myocardial infarction (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-17
   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: Vitamin D, multivitamin
Current Illness: none
Preexisting Conditions: prediabetes, enlarged heart, hyperlipidemia.
Allergies: codeine, valium, Crestor
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: My husband stated that he did not feel good after the vaccine the next morning, later he went to pick up hay and died on someone''s property from the acute coronary syndrome.


VAERS ID: 1312649 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-06
Onset:2021-05-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Cardioversion, Death, Dyspnoea, Haematemesis, Nausea, Pain, Pallor, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (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), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-12
   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: Sertraline, Mirtazapine, memantine, Lamotrigine, Donepezil, Acetaminophen-Codeine
Current Illness: Unknown
Preexisting Conditions: Dementia, wheelchair bound
Allergies: NKDA
Diagnostic Lab Data: Covid PCR performed, result pending
CDC Split Type:

Write-up: On 5/12/2021 patient was complaining of generalized body aches, later in the morning when going to a pain management clinic, patient subsequently became nauseous and vomited several times during the course of the day. Reportedly had episode of dark emesis as well. Patient was then found by family around 10pm unresponsive, pale, w/ difficulty breathing, EMS was called, patient was found to be in cardiac arrest in asystole. Patient possibly had v-fib during transport and was defibrillated twice before becoming asystolic again. Patient was subsequently pronounced dead in the Emergency Department on 5/12/21 at 11:04pm.


VAERS ID: 1312771 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Virginia  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210510294

Write-up: FEMALE ISSUES; BLOOD CLOTS; This spontaneous report received from a consumer concerned multiple patients. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported and has been requested. On an unspecified date, the consumer called and reported that he had read in newspaper that women had gotten blood clots and 3 passed away with female issues. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of female issues on an unspecified date, and the outcome of blood clots was not reported. This report was serious (Death, and Other Medically Important Condition).; Sender''s Comments: V0. 20210510294 -COVID-19 VACCINE AD26.COV2.S- Female issues, Blood clot. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1312812 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-03-17
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebral haemorrhage, Endotracheal intubation, Headache
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-18
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210517658

Write-up: BLEEDING IN BRAIN; INTUBATED; SEVERE HEADACHE; This spontaneous report received from a consumer via company representative concerned a 45 year old female with unknown race and ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose 1 total, administered on 2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 17-MAR-2021, the patient experienced severe headache and went to the hospital and diagnosed with bleeding in brain. During hospitalization patient was intubated .On 18-Mar-2021,patient died due to bleeding in brain. Patient was hospitalized for 1 day. It was unknown whether autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the intubated and severe headache was not reported. This report was serious (Death, and Hospitalization Caused / Prolonged).; Sender''s Comments: V0:20210517658- covid-19 vaccine ad26.cov2.s-Bleeding in brain, intubated. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: BLEEDING IN BRAIN


VAERS ID: 1313237 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Mechanical ventilation, Suspected COVID-19
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 30
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: Exposure to COVID-19
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210514186

Write-up: WAS ON VENTILATOR; SUSPECTED COVID-19 INFECTION; DEATH; This spontaneous report received from a media article via a company representative concerned a 61 year old female of unspecified race and unspecified Ethnic origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included exposure to covid-19.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on 10-MAR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. A day later of vaccination patient traveled extensively and returned home nine days later. On an unspecified date in MAR-2021, the patient was not feeling well and had difficulty in breathing. Later, patient''s sister drove her to the hospital where she had ups and downs but was eventually put on a ventilator. On an unknown date in APR-2021, the patient died due to unknown cause of death. It was unspecified if autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died an APR-2021 and the outcome of was on ventilator and suspected covid-19 infection was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening).; Sender''s Comments: V0: 20210514186-covid-19 vaccine ad26.cov2.s-Death, was on ventilator, suspected covid-19 infection. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1313560 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-05-11
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I21.3 - STEMI (ST elevation myocardial infarction) (CMS/HCC)


VAERS ID: 1313575 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-04-20
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Atrial fibrillation, Cystitis, Haematuria, Pneumonia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Supraventricular tachyarrhythmias (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), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-11
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: J18.9 - Left lower lobe pneumonia I48.91 - Atrial fibrillation with RVR (CMS/HCC) N17.9 - Acute kidney injury (CMS/HCC) N30.01 - Acute cystitis with hematuria


VAERS ID: 1313585 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hepatic encephalopathy
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Noninfectious encephalopathy/delirium (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: K72.90 - Hepatic encephalopathy (CMS/HCC)


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=41&PERPAGE=100&VAX=COVID19&VAXTYPES=COVID-19&DIED=Yes


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166