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

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



Case Details

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VAERS ID: 1683731 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-08
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 INC202101134188

Write-up: female in her 40s that died after getting the Pfizer covid vaccine; This is a spontaneous report from a contactable consumer. This consumer reported for a female patient in her 40''s which included that. A 5-decade-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Other Products, Patient History and Investigation Assessment was Not Provided. The patient experienced female in her 40s that died after getting the pfizer covid vaccine (death) (death, medically significant) on an unspecified date. Reporter reports that three people got the Pfizer covid 19 vaccine. One is a 63-year-old female, and she had a stroke her verbatim was bleed in the head. Then a female in her 40s that died after getting the Pfizer covid vaccine. Then a male that was 25-30 years old and he died. She does not have further details to provide on female in her 40s that died after the covid vaccine. Later Caller stated during call that she was speaking with another agent, but it was only this Caller on the line when this agent answered. Caller states that she knows a 63-year-old female who received the Pfizer Covid-19 vaccine then had a stroke, "bleed in the head" afterwards. Caller also states that she knew a female in a 40''s (years) and a male between the age of 25-30 years who both died after receiving the Pfizer Covid-19 vaccine. Caller is asking why is Pfizer not reporting the side effects to VAERS? Caller states that the data on VAERS has stopped counting the fatalities from the Pfizer Covid-19 vaccine and the death count exceeds 12,000. Caller stated that the agent before this agent was unable to answer any of her questions (this agent unaware of which Pfizer department due to no warm transfer being performed and the Caller was the only person on the line when this agent answered the Call). Caller provided the following possible feedback: Caller asks why did withheld, approve the Pfizer Covid- 19 vaccine? Caller asks why does she have anything to do with this approval of the Pfizer Covid-19 vaccine? Caller states that the Pfizer Covid-19 vaccine has metals and is asking how is it being passed through the FDA and Pfizer? Normally with other shots, they take years to get approved. FDA only allows, if people die, they don''t put it on the market. Caller states that the data on VAERS has stopped counting the fatalities from the Pfizer Covid-19 vaccine and the death count exceeds 12,000. Caller is asking if "We had COVID, we had the antibodies, why do we have to get the shot?" Confirmed with caller that she is talking about mandates from withheld and employers. Caller asks why did withheld, approve the Pfizer Covid-19 vaccine Caller asks why does she have anything to do with this approval of the Pfizer Covid-19 vaccine Caller states that the Pfizer Covid-19 vaccine has metals and is asking why is it being approved? The patient died on an unspecified date. It was not reported if an autopsy was performed. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101134213 same reporter/drug/event, different patient.; Reported Cause(s) of Death: unknown cause of death


VAERS ID: 1683905 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-01
Onset:2021-09-05
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   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: client fully vaccinated, patient died 09/05/2021-Cause: Complications of COVID-19


VAERS ID: 1684121 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-19
   Days after onset: 121
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness:
Preexisting Conditions: HIV
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death


VAERS ID: 1684500 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-01
Onset:2021-08-29
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / UNK - / -

Administered by: Private       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: 2021-09-08
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID positive on 8/29/21
CDC Split Type:

Write-up: Patient received Pfizer on 2/8/2021 and 3/1/2021. Patient was admitted to the hospital on 8/29/2021 for COVID pneumonia, and acute on chronic respiratory failure. Patient died on 9/8/2021.


VAERS ID: 1684691 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-08-19
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Endotracheal intubation, General physical health deterioration, Hypoxia, Intensive care, Multiple organ dysfunction syndrome, SARS-CoV-2 test positive
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 (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-08
   Days after onset: 20
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: allopurinol (ZYLOPRIM) 100 MG tablet amLODIPine-benazepril (LOTREL) 10-20 MG capsule ascorbic acid (VITAMIN C) 250 MG tablet aspirin (HALFPRIN) 81 MG tablet Calcium Carbonate-Vitamin D (CALTRATE 600+D PO) clopidogrel (PLAVIX) 75 MG tablet o
Current Illness: None known
Preexisting Conditions: Hyperlipidemia Mitral regurgitation HTN (hypertension) Gout Depression Rotator cuff arthropathy Obesity (BMI 30-39.9) Gastroesophageal reflux disease without esophagitis IFG (impaired fasting glucose) Bilateral wrist pain Thrombocytopenia CAD S/P percutaneous coronary angioplasty S/P cardiac cath 08/21/20 Osteoarthritis of right knee, unspecified osteoarthritis type S/P TKR (total knee replacement), right Memory loss Tremor
Allergies: Latex (contact dermatitis), Celebrex (rash), lipitor (dizziness), penicillins
Diagnostic Lab Data: COVID-19 test positive on 8/19/2021
CDC Split Type:

Write-up: Patient presented to emergency department on 8/19/2021 with shortness of breath. He was found to be COVID-19 positive and admitted for further management. He was transferred to the ICU on 8/23/2021 due to worsening hypoxia. He was intubated on 8/28/2021. Patient''s condition further deteriorated into multisystem organ failure. He was placed on comfort measures on and expired on 9/8/2021.


VAERS ID: 1684695 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-02-13
Onset:2021-02-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Confusional state, Death, Disorientation, Feeling abnormal, Impaired driving ability, Loss of personal independence in daily activities, Social avoidant behaviour
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-21
   Days after onset: 96
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fentanyl Patch; Fluconazole; Clonidine; Albuterol; Atorvastatin; Baclofen; Fluoxetine; Spironolactone; Losartan; Furosemide; Allopurinol; Hydralazine; Estradiol; Verapamil; Lansoprazole; Isosorbide; Clopidogrel; Metoprolol; Nitroglycerine;
Current Illness: Phenomena - UTI
Preexisting Conditions: COPD - Lung Fungus - Asthma - Congestive heart failure - Back and leg
Allergies: Codeine - Morphine
Diagnostic Lab Data: None - We did not put the two together until she was in the hospital in May.
CDC Split Type:

Write-up: Became unable to take care of her daily activities, unable to remember anything and when she passed away we found that none of her bills had been paid since before she took her 2nd shot. She was disoriented, confused, didn''t know where she was or remember speaking with anyone on the phone and just felt overall worse. Since she had the chronic health issues she/we were not aware she had gotten worse as she pulled away from everyone and kept telling us "this episode was just lasting longer". When she passed and I started going through her things I realized it all started after the shot. Nothing had been taken care of after that date. She also had been driving up until March, she herself stopped driving stating she didn''t feel comfortable in driving any longer.


VAERS ID: 1684789 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-04-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 143
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sinemet
Current Illness: Parkinson''s disease
Preexisting Conditions: Parkinson''s disease - diagnosed in 1995
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient brought to the ED on 4/15/2021 at 0330 with increased weakness. Patient takes Sinemet every 3 hours and last Sinemet dose was sometime late on 4/14/2021. Patient stated the medication wore off sooner than it should have. Patient was discharged to home on 4/15 at 0551. Patient was seen again in the ED on 7/17/2021 at 2100 for weakness. Again, brought in by EMS. No medications were given in the ED. Patient discharged to home on 4/17/2021 at 2345.


VAERS ID: 1684790 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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: 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: E11.2, D51.9,E55.9,E87.0,F03.91,F32.9,G31.1,K86.89,M15.0,N18.30,G63.8,E86.9,H91.90,I10,K21.00,Z68.1,Z87.430
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT IS RESIDENT OF HEALTH AND REHAB FACILITY. PT WAS FOUND UNRESPONSIVE ON 9/5/21 BY NURSE.


VAERS ID: 1684819 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-14
Onset:2021-08-10
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Death, Diarrhoea, Dyspnoea, General physical health deterioration, Hypoxia, Inappropriate schedule of product administration, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Medication errors (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Citalopram, fluticasone-salmeterol Diskus, simvastatin, gabapentin, quetiapine, meloxicam, acetaminophen, preservision ared 2, ferrous sulfate, colchicine, xanax, nystatin topical powder, ketoconazole topical, mucinex, omeprazole
Current Illness:
Preexisting Conditions: HTN, COPD, HLD, CHF, anxiety, depression
Allergies: Flagyl, Polysporin ointment, shellfish
Diagnostic Lab Data: patient reported positive COVID test on 8/10/21. PCR COVID-19 test positive in hospital on 8/15/2021
CDC Split Type:

Write-up: 8/14/2021 Admit Hospital. Patient presented to emergency room with shortness of breath for the last 4 days with weakness and decline in status and diarrhea. Her oxygen saturation was low in the low 90s. home oxygen dependent. Tested positive for COVID-19 from PCR on 8/15/21. Diagnosed with: COVID-19 pneumonia, acute on chronic hypoxic respiratory failure. Transferred to Hospice 8/20/21. patient died on 8/25/21. Note: COVID-19 Moderna vaccine previously given: First dose: 03/08/21 Lot Number 025A21A; Second dose: 04/14/21 Lot Number 030B21A


VAERS ID: 1684866 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-02-04
Onset:2021-07-22
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-15
   Days after onset: 24
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 24 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: It was noted that he had weakness in his legs and some weakness in his arms and a diagnosis of Guillain-Barre.


VAERS ID: 1684882 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-08-12
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Hypoxia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-29
   Days after onset: 17
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST IN JULY 2021, SOB WORSENED, SENT BACK TO HOSPITAL DUE TO HYPOXIA,, THEN DISCHARGED TO HOSPICE WHERE HE PASSED AWAY.


VAERS ID: 1684903 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-08-07
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-28
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COUGH, SOB, HX OF MOTHER BEING POSITIVE FOR COVID, PT TESTED POSITIVE FOR COVID


VAERS ID: 1684960 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-15
Onset:2021-08-17
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Confusional state, Lung infiltration, Pulmonary oedema, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-23
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: CONFUSION, POSITIVE COVID TEST, BILATERAL PULMONARY INFILTRATE, PULMONARY EDEMA


VAERS ID: 1684977 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-09-05
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: type 2 diabetes, hypertension, & obesity
Allergies: unknown
Diagnostic Lab Data: COVID-19 PCR positive on 8/16/2021.
CDC Split Type:

Write-up: 1st vaccine given on 1/20/21, 2nd dose given on 2/9/21; tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21.


VAERS ID: 1684982 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-24
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood culture positive, COVID-19, Myalgia, Pyrexia, SARS-CoV-2 test positive, Staphylococcal infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-27
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST, MYALGIAS, FEVER, BLOOD CULTURE POSITIVE FOR MSSA


VAERS ID: 1685005 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-23
Onset:2021-08-01
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E110140 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest pain, Death, Dyspnoea, Malaise, Oxygen saturation decreased, Respiratory failure
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), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: 2021-08-07
   Days after onset: 6
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: aceaminophen-ibuprofen, amlodipine, atorvastatin, doxycycline, ergocalciferol, hydralazine, ivermectin, metformin, multivitamin, Visine, valsartan, zinc sulfate
Current Illness:
Preexisting Conditions: diabetes, hypertension, right BKA, CAD
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/1/2021: patient admitted. Apparently, he has been ill for a few days. He was given antibiotic as outpatient basis - including oral ivermectin. He was diagnosed with COVID at outside facility. He failed outpatient treatment. His oxygen has been going down. He presented to the emergency department with shortness of breath as well as chest pain. Diagnosed with Covid pneumonitis, hypoxic resp failure Note: patient previously vaccinated with Covid-19 vaccine: First dose: 01/02/21 Lot Number E110140;Second dose: 01/23/21 Lot Number EL3248 8/7/2021: patent Died


VAERS ID: 1685011 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-08-26
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cardiac arrest, Dyspnoea, Pyrexia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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 (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), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SOB, FEVER, WEAKNESS, POSITIVE COVID TEST, RESPIRATORY FAILURE, CARDIAC ARREST


VAERS ID: 1685045 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-08-20
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, SARS-CoV-2 test positive
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
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: DIARRHEA, POSITIVE COVID TEST, HX OF DIABETES AND HTN; SEIZURE DISORDER


VAERS ID: 1685068 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-12
Onset:2021-08-16
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Mental status changes, Pneumonia, Respiratory syncytial virus infection, Respiratory syncytial virus test positive, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-27
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PNEUMONIA, POSITIVE COVID TEST, RSV POSITIVE, ALTERED MENTAL STATE


VAERS ID: 1685087 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-17
Onset:2021-09-02
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-06
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of myeloma, thyroid cancer, breast cancer, RA, COPD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient diagnosed, hospitalized and expired with COVID 19 while fully vaccinated


VAERS ID: 1685092 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-07
Onset:2021-08-10
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Cardiovascular disorder, Chronic kidney disease, Condition aggravated, Death, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-17
   Days after onset: 7
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:
Preexisting Conditions: Cardiovascular disease, Chronic Renal disease, High blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is fully vaccinated and died in hospice care. Case was previously living in a Long term care facility and recently relocated to hospice as in-patient in hospital. Case tested Covid positive at hospital and didn''t show any signs and symptoms. Case was told his heart and kidney medical conditions were declining. Case had chronic conditions listed previously. Case died about a week later after being admitted to hospice.


VAERS ID: 1685095 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-27
Onset:2021-08-10
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Decreased appetite, Dyspnoea, Fatigue, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-15
   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:
Current Illness:
Preexisting Conditions: Diabetes Mellitus COPD Cardiovascular disease Hypertension Immunosuppressive condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient started with symptoms on Friday 8/6/21. They decided to test him on Tues 8/10/21 and he came back positive on Wed 8/11/21. Patient has a history of COPD, CHF, Diabetes, Prostate Cancer, CVA. He started with SOB, cough, loss of taste and smell and now is very fatigued, has a loss of appetite and has low O2 saturation. DON of PHH denied that he has any stomach concerns (no vomiting or diarrhea). His O2 sat has been in the high 70''s and they are concerned about him. They may look into if he has pneumonia, as he has not had a chest xray, however they have already prescribed antibiotics, steroids, ivermectin, and vitamins C, D, and Zinc


VAERS ID: 1685099 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-26
Onset:2021-08-17
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Respiratory distress, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PRESENTED IN RESPIRATORY DISTRESS, COVID POSITIVE, PNEUMONIA DUE TO COVID


VAERS ID: 1685126 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-05
Onset:2021-09-02
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-02
   Days after onset: 0
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nursing notes have been submitted into system, death summary is not available yet.


VAERS ID: 1685155 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-16
Onset:2021-08-19
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-06
   Days after onset: 18
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:
Current Illness:
Preexisting Conditions: O2 dependent COPD.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient diagnosed and hospitalized with COVID 19. Patient expired.


VAERS ID: 1685163 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-08-11
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cerebrovascular accident, Death, Pneumonia, SARS-CoV-2 test positive
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), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-22
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: RECENT CVA; HX OF COPD, HTN, ASTHMA; PNEUMONIA DUE TO POSITIVE FOR COVID


VAERS ID: 1685183 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-08-20
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Death, Dyspnoea, Heart rate decreased, Oxygen saturation decreased, Procalcitonin increased, Tachypnoea, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 5
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: Trelegy Ellipta 100-62.5-25mcg 1 puff daily, lisinopril 10mg daily, prednisone 10mg daily, albuterol 2 puffs q4hours prn, atorvastatin 20mg daily, cetirizine 10mg daily, fluticasone 2 sprays each nostril daily, Floranex 100 million cell gra
Current Illness:
Preexisting Conditions: morbid obesity, HTN, moderate persistent asthma, OSA, HLD, allergic rhinitis, long term systemic steroid user
Allergies: Aleve, Fentanyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 03/11/2021 and 04/08/2021. On 8/20/2021, pt presented to ED with increasing shortness of breath. Pt was admitted to a hospital on 8/17/2021 and diagnosed with COVID-19 pneumonia. She was discharged on 8/20/2021 with 4 L NC oxygen. Once discharged patient began to desaturate to 80% and called EMS. Patient was transported to ED and placed on HFNC 50/40 then titrated up to 60/60 and then later 70/60. Her lab work demonstrated elevated procalcitonin and her x-ray demonstrated a multifocal pneumonia. She was given dexamethasone, Rocephin and remdesivir. On morning of 8/25/21 she was noted to be significantly tachypneic with RR to 40s and slightly altered. Despite ongoing treatment, she declined. Patient expired on 8/25/21.


VAERS ID: 1685188 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-02
Onset:2021-08-12
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Death, Decreased appetite, Dyspnoea, Endotracheal intubation, Fatigue, Hypophagia, Infarction, Nausea, Pain, Pneumocystis jirovecii pneumonia, Positive airway pressure therapy, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 90 mcg 2 puffs q4h prn, amlodipine 5mg daily, Eliquis 5mg BID, benzonatate 200mg TID PRN, Tylenol PM 25-500mg nightly prn, Lomotil 2.5-0.025mg 2 tabs QID prn, famotidine 20mg BID, ibuprofen 200mg 2 tabs QID prn
Current Illness:
Preexisting Conditions: HTN, ED, HLD
Allergies: Ciprofloxacin, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 03/11/2021 and 04/02/2021. On 7/12 he began developing symptoms of fatigue, chills, low-grade fevers, body aches, intermittent nausea, poor p.o. intake, poor appetite, some dry cough. He tested COVID positive on 7/16 and continued symptomatic treatment at home. Patient was then admitted 7/24 and discharged on 7/30 with oxygen. Received decadron during this stay. Returned to ER on 8/12 due to worsening shortness of breath. Received vancomycin and cefepime. Started on BiPAP then eventually intubated on 8/17. Patient''s respiratory status continued to worsen. Multifocular infarcts noticed on 8/22. Patient treated for PJP on 8/23. Family planned withdrawal of care on 8/24 after discussion of patient''s poor prognosis. Patient expired on 8/25/21.


VAERS ID: 1685194 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-23
Onset:2021-08-15
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NO LOT # AVAILA / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: 2021-08-25
   Days after onset: 10
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, fatigue, cough, positive for COVID


VAERS ID: 1685242 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-19
Onset:2021-08-31
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cerebrovascular accident, Death, Endotracheal intubation, Extubation, Hypoaesthesia, Paraesthesia
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), 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), Guillain-Barre syndrome (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-31
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes.


VAERS ID: 1685297 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2020-12-30
Onset:2021-08-22
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Cough, Pneumonia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-23
   Days after onset: 1
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: Donepezil 10 mg bid, Amlodipine 5mg daily, Benazepril 10mg daily, Escitalopram 20mg daily, Furosemide 40 mg daily, Memantine HCL 10 mg bid, Multivitamin daily,
Current Illness: None
Preexisting Conditions: HIstory of Tuberculosis. Hypertension, Late onset Alzheimers with behavioral disturbances, History of a colon resection.
Allergies: NKDA
Diagnostic Lab Data: Covid positive 8-16-2021
CDC Split Type:

Write-up: Fever, cough, recent pneumonia diagnosed by chest xray.


VAERS ID: 1685315 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-18
Onset:2021-09-08
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Cardio-respiratory arrest, Cardioversion, Death, Dyspnoea, Endotracheal intubation, Gastrointestinal tube insertion, Hypoxia, Intensive care, Mechanical ventilation, Oxygen saturation decreased, Pulseless electrical activity, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), 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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (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: 2021-09-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted to COVID floor on 8/25/21 for acute hypoxic respiratory failure secondary to bilateral pneumonia COVID-19. She was initiated on dexamethasone and remdesivir. Pulmonology consulted 8/31 for worsening hypoxemia, on heated high-flow nasal cannula and alternating with noninvasive positive pressure ventilation. On 09/02 patient was transferred to the COVID19 ICU for worsening respiratory status. Patient requested multiple times to delay intubation and maintain on AVAPS. She did have a feeding tube placed and was receiving tube feeds. She essentially became dependent on noninvasive ventilation unable to wean. She did attempt self proning with some improvement in her oxygenation. This morning, patient''s oxygen saturations dropped to 60s with increased work of breathing despite noninvasive ventilation and self proning. Discussed with patient again and she was agreeable to being intubated and family agreed. Patient sedated and intubated, unfortunately shortly after intubation patient had a PEA arrest and Code Blue called. See previous note for details. Ultimately, after multiple rounds of CPR, epinephrine, defibrillations without persistent return of spontaneous circulation and approx 35 minutes resuscitation efforts, all resuscitation efforts stopped and time of death called at 08:07am.


VAERS ID: 1685326 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-02
Onset:2021-09-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-03
   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: MS Contin 15mg, Lasix 20mg, Clonazepam 0.5mg, Trazadone, Haldol, Morphine, Vicks Vaporub, Albuterol Neb, Hydroxyzine, Prednisone, Compazine, Phenergan, Coreg, Zestril, Anti-fungal powder, Miralax, Zofran, Prilosec, Acetaminophen, Imodium,
Current Illness:
Preexisting Conditions: Chronic Systolic Congestive Heart Failure, Aneurysm of iliac artery, COPD, Cardiomyopathy, hypertension, Obesity, Atrial Fibrillation, Rheumatoid Arthritis
Allergies: Ciprofloxacin, metronidazole
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient of Hospice who requested to have Covid Vaccine. Our Community Paramedic, took the vaccine to the Hospice on 9/2/2021. He administered the vaccine and waited 15 minutes to observe for reactions. No adverse reactions were noted. The following morning we received a call from the nurse at the Hospice House that pt was pronounced deceased on 9/3/2021 in early am.


VAERS ID: 1685347 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-27
Onset:2021-08-17
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Apnoea, Cough, Death, Delirium, Diarrhoea, Dysphagia, Dyspnoea, Hypoxia, Nausea, Pneumonia, Respiratory failure, Sneezing, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carvedilol 6.25mg BID, Isosorbide dinitrate 10mg daily Tylenol 500mg 1 tablet q6h prn, aspirin 81mg daily, atorvastatin 40mg ? tab daily, vitamin D3 5000unit daily, folic acid 1mg daily, furosemide 40mg 1 tab daily, Levemir 12 units daily i
Current Illness:
Preexisting Conditions: T2DM with nephropathy, Stage IV renal insufficiency, HTN, HLD, CAD, CHF, Complete Heart Block, Cardiomyopathy
Allergies: Influenza Virus Vaccines, Penicillins, Promethazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/6/2021 and 3/27/2021. Patient started having cough and sneezing around 8/11 after going out of town. She then developed nausea, vomiting, and diarrhea on 8/12. Patient presented to ED on 8/17, o2 sat was 75% on room air. She was placed on a non-rebreather but was saturating at 100%. Imaging showed multifocal pneumonia. Patient was treated with dexamethasone, remdesivir, and baricitinib . Patient continued to experience respiratory failure. Patient developed AKI and acute delirium and was unable to safely swallow. Dobhoff tube was placed, and she received enteral nutrition. She developed worsening hypoxia on 8/25/21. Patient continued to have acute worsening of breathing, became apneic, and expired on 8/25/21.


VAERS ID: 1685352 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-01-27
Onset:2021-05-31
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bacteraemia, Blood culture positive, Cardiac failure congestive, Computerised tomogram thorax, Cough, Death, Dyspnoea, Enterococcal infection, Pneumonia, Pneumonia aspiration, Pneumonia bacterial, Productive cough, Sepsis, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-15
   Days after onset: 45
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 42 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, albuterol, amlodipine, benzonatate, calcium carbonate, breo ellipta, duoneb, macular vitamin, magnesium hydroxide, melatonin, metoclopramide, Montelukast, omeprazole, ondansetron, refresh tears, spironolactone, apixaban, levo
Current Illness:
Preexisting Conditions: Asthma, Coronary artery disease, DJD (degenerative joint disease), DVT (deep venous thrombosis) (HCC), Hypercoagulable state (HCC), Hypertension, Hypothyroidism, Iron deficiency anemia, Osteopenia, and Seasonal allergies.
Allergies: fexofenadine, meloxicam, sulfa
Diagnostic Lab Data: 5/3/21 CTA chest: neg for embolism 5/3/21 Chest: Marked interval improvement in previously seen extensive consolidation within the left lung. Minimal residual is seen. 5/3/21 blood culture x 2: enterococcus faecium VRE
CDC Split Type:

Write-up: Had COVID 19 in November 2020 and again in May 2021. Came to hospital with complaint of worsening shortness of breath associated with cough and sputum expectoration. Recently discharged for recurrent pneumonia. WBC 20. Started on ceftriaxone, azithromycin and dexamethasone. Placed on 2L NC. Diagnosed with community acquired bacterial pneumonia. Had VRE bacteremia. Switched to daptomycin and discharged on linezolid x 10 days. Readmitted on 5/29/21 with SOB, cough, and new left-sided pneumonia. Discharged 6/9/21. Admitted again on 6/10/21 for aspiration pneumonia and CHF exacerbation. Placed on unasyn and discharged on augmentin. Admitted again on 6/28/21 for sepsis secondary to pneumonia. Went comfort measures at this time and discharged with hospice. Died 7/15/21


VAERS ID: 1685364 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-16
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Cough, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: 2021-08-29
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: All Day Pain Relief 220mg bid. Ipratropium 0.03%, 1 puff in each nostril bid. Levothyroxine 88mcg daily. Polyeth Glycol 1 capful in water daily.
Current Illness: none
Preexisting Conditions: Hydrocephaly, Benign Prostatic Hypertrophy, Coronary Artery Disease, Tremors, Hypothyroidism, Anemia
Allergies: NKDA
Diagnostic Lab Data: Covid positive 08/16/2021
CDC Split Type:

Write-up: Fever, cough


VAERS ID: 1685422 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-16
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: 2021-08-30
   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: Dofetilide 250mcg daily, Polyethyl Glycol powder 1 capful with water daily. ASA 81 mg daily. Donepezil 5 mg daily. Latanoprost sol .005% 1 drop to each eye at night. Senna 0.8 mg daily. Levothyroxine 25 mcg daily. Lorazepam 0.5 mg twi
Current Illness: none known
Preexisting Conditions: Hypothyroidism. Senile Hyperkeratosis. Scoliosis deformity of the spine. Dementia with behavioral disturbances. Alzheimers Disease. Atrial Fibrillation.
Allergies: Iodine contrast
Diagnostic Lab Data: Covid positive 08/16/2021
CDC Split Type:

Write-up: Fever, cough, runny nose


VAERS ID: 1685430 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-05
Onset:2021-09-05
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-06
   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: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: unknown


VAERS ID: 1685448 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Death, Dyspnoea, Fatigue, Gait inability, Laboratory test, Mobility decreased, SARS-CoV-2 test positive, Septic shock
SMQs:, Anaphylactic reaction (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), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-27
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: Alzheimer''s
Allergies: None
Diagnostic Lab Data: Various Test Ran
CDC Split Type:

Write-up: Tiredness unable to get out of bed and walk Acute Respiratory Failure COVID 19 Positive Septic Shock Shortness of Breath Expired on 08/27/2021 *She lived with a caregiver. Her son called to report but had limited information. He says that the caregiver has more information.


VAERS ID: 1685498 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-16
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: 2021-09-04
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carb/Levo 25-100 mg tid. Amantadine 100 mg bid. Clonazepam 0.5 mg every hs. Bisacodyl 5mg daily. Olanzapine 2.5 mg every hs. Citalopram 20 mg daily. Simethicone 180 mg bid. Oxycodone 5 mg bid. Senna s 8-6-50 3 tablets bid. Lisinop
Current Illness: none known
Preexisting Conditions: Dementia, Debility, Hypertension, Parkinson Disease, Spondylosis, Allergic Rhinitis, Osteoarthritis, Anxiety, Depression, Schizophrenia.
Allergies: NKDA
Diagnostic Lab Data: Covid positive 08/18/2021
CDC Split Type:

Write-up: Fever, sore thoat, cough.


VAERS ID: 1685546 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-08-14
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Coma scale abnormal, Computerised tomogram head normal, Death, Endotracheal intubation, Hypotension, Pulmonary mass, Respiratory failure, SARS-CoV-2 test positive, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-22
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen, amlodipine, amoxicillin-clavulanate, aspirin, baclofen, gabapentin, metoprolol tartrate, pantoprazole, sulfamethoxazole-trimethoprim
Current Illness:
Preexisting Conditions: neurogenic bladder with recurrent UTI, hypertension
Allergies: morphine
Diagnostic Lab Data: Tested positive for covid 8/14/21.
CDC Split Type:

Write-up: 8/14/21: patient brought to ED as she was found unresponsive by family last time was seen was 8:00 p.m. on arrival to ED patient has to be intubated for low GCS round 3 stroke alert team was activated head CT is negative chest x-ray significant for right upper lobe mass patient required norepinephrine as she was hypotensive. COVID test PCR came back positive. admitted to COVID unit Note: patient previously vaccinated with Pfizer Covid-19 vaccine on 4/26/21 & 5/17/21. Diagnosed with hypoxic respiratory failure secondary to covid pneumonia. 8/22/21: patient died.


VAERS ID: 1685561 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-08-12
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, COVID-19, Cardiac arrest, Chills, Death, Disease risk factor, Hypotension, Intensive care, Myalgia, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Therapeutic response decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-06
   Days after onset: 25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, Amiodipine,quin
Current Illness: UTI
Preexisting Conditions: Bladder Cancer 2004, Hypertension, Renal Cancer (Nephrectomy 2004)
Allergies: Penicillin
Diagnostic Lab Data: COVID Anti-Spike IgG Positive, COVID Anti-Spike Nucleocapsid IgG Negative, COVID Rapid Molecular Positive,
CDC Split Type:

Write-up: Presented to the ED with chief complain of fever, myalgia and noted low oxygen saturation. He was possibly exposed to the coronavirus at his bar during a hosted festival from 8/6-8/8 where one attendant called to inform him he tested positive to the coronavirus. His symptoms started with fever, myalgia, chills about 1-2 weeks prior to his admit on 8/24/21, In the ED, he was desaturating to the 50s and placed on a HFNC. His code status is DNR/DNI. He has received remdesivir, decadron, 2 doses of barticinib and therapeutic anticoagulation for being at high thrombotic risk from the coronavirus infection. Patient was managed in the ICU from the time of admission. On the night of 9/5/21 patient became hypotensive and not responding adequately to IV fluids. Patient was found to have asystole at 3:06 AM on 9/6/21. Pronounced dead at 3:06 AM.


VAERS ID: 1685563 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-23
Onset:2021-09-04
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Chronic obstructive pulmonary disease, Condition aggravated, Death
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)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-04
   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: albuterol, vitamin C, aspirin, zebeta, fibercon, calcium, vitamin D, plavix, tricor, proscar, lasix, gabapentin, glucosamine, guafenesin, novolog, ketoconazole, lisinopril, loratadine, magnesium oxide, metformin, multivitamin, nitro, ropini
Current Illness:
Preexisting Conditions: acute respiratory failure, chronic kidney disease, obesity, nocturnal hypoxemia, hypersomnia, vitamin D deficiency, hyponatremia, PTSD, diabetes mellitus, diabetic neuropathy, coronary artery disease, hypertension, dyslipidemia, COPD
Allergies: iodine, tamsulosin, atorvastatin, doxycycline monohydrate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Decedent on hospice for acute respiratory failure due to chronic obstructive pulmonary disease.


VAERS ID: 1685567 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-12
Onset:2021-08-29
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19 pneumonia, Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-03
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin,lipitor, vitamin B, iron, midodrine, potassium, gluconate, brilinta, vitamin D, nitro
Current Illness:
Preexisting Conditions: hyperlipidemia, hypertension, coronary artery disease, chronic kidney disease, cerebral infarction
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 8/29/2021, decedent presented to the ER with a three day duration of worsening shortness of breath. He was admitted to the hospital and discharged home on 9/1/2021 with COVID pneumonia.


VAERS ID: 1685584 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-08
Onset:2021-08-15
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Lung neoplasm malignant, Productive cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SOB, positive COVID test, productive cough, current lung CA


VAERS ID: 1685607 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Death, Dyspnoea, Dyspnoea exertional, Electrocardiogram normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-23
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: predaxa, crestor, matopolol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ekg - normal
CDC Split Type:

Write-up: chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died


VAERS ID: 1685619 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-08-18
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, COVID-19, COVID-19 pneumonia, Cough, Death, Decreased appetite, Diarrhoea, Dyspnoea exertional, Fatigue, Gastroenteritis viral, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (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), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-09
   Days after onset: 22
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: Diltiazem, furosemide, glimepiride, levothyroxine, memantine, metoprolol, miralax, KCL, entresto, sertraline, simvastatin, timolol Malaete eye, travoprost eye, warfarin
Current Illness:
Preexisting Conditions: Afib, CHF, glaucoma, hyperlipidemia, hypothyroid, diabetes, ocular shingles, mild dementia
Allergies: hydrocodone, oxycodone
Diagnostic Lab Data: COVID-19 PCR positive on 8/18/21
CDC Split Type:

Write-up: 8/18/2021: admitted with COVID breakthrough Pt reports fully vaccinated in April 2021. Reports since Sunday having fatigue, diarrhea, mild cough, loss of taste/appetite, and exertional dyspnea. reported testing positive for COVID-19 on 8/16/21. 1st vaccine 3/8/2021 second 4/15/2021. Diagnosed with: COVID-19 pneumonia, acute hypoxic respiratory failure, viral enteritis 9/9/21: patient died.


VAERS ID: 1685644 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-13
Onset:2021-02-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024MZOA / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death, Decreased appetite, Feeling abnormal, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-22
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel
Current Illness: Lewy Bodie dementia Lyden factor five
Preexisting Conditions: Lyden factor five -Lewy bodies dementia
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: He received the vaccine on 2/13/21 by 2/15/21 he was not feeling himself didn?t really eat by 2/17/21 he couldn?t walk by 2/19/21 he was admitted to hospice and by 2/22/21 he passed away


VAERS ID: 1685648 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-21
Onset:2021-08-23
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Blood culture positive, COVID-19, Death, Dialysis, Disseminated intravascular coagulation, Dyspnoea, Enterobacter bacteraemia, Enterobacter test positive, Gastrointestinal haemorrhage, Inappropriate schedule of product administration, International normalised ratio decreased, Mechanical ventilation, Oxygen saturation decreased, Platelet count decreased, Positive airway pressure therapy, SARS-CoV-2 test positive, Seizure, Shock
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 1-2 puffs 4 times daily as needed, atorvastatin, 40 mg daily, azelastine 1 drop both eyes twice daily as needed, bupropion 300 mg daily, cetirizine 10 mg daily, cinacalcet 30 mg daily, citalopram 40 mg daily, ergocalciferol 1250 m
Current Illness:
Preexisting Conditions: congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, sleep apnea, cirrhosis, chronic obstructive, pulmonary disease, history of hepatitis C, esophageal varicies, anemia, vitamin D deficiency, pulmonary hypertension, chronic pain syndrome, chronic kidney disease
Allergies: Ibuprofen, tramadol, methocarbamol
Diagnostic Lab Data: COVID Positive on 8/23/2021; INR 4.4 on 9/1/2021; platelets 14 on 8/29/2021; blood culture positive for enterobacter cloacae
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442.


VAERS ID: 1685668 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-02
Onset:2021-08-14
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Brain hypoxia, COVID-19, COVID-19 pneumonia, Cough, Death, Dyspnoea, Endotracheal intubation, Gastrooesophageal reflux disease, General physical health deterioration, Headache, Intensive care, Pneumonia bacterial, Pyrexia, Respiratory distress, Respiratory tract congestion, SARS-CoV-2 test positive, Use of accessory respiratory muscles, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic 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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-31
   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: Albuterol MDI PRN, Aspirin 81 mg QD, Atorvastatin 40 mg QD, Calcium Carbonate+Vitamin D BID, Cholecalciferol 5000 units QD, Citalopram 20 mg QD, Fluticasone nasal QD, folic acid 1 mg QD, Gabapentin 300 mg BID, Hydroxychloroquine 200 mg QD
Current Illness:
Preexisting Conditions: Anxiety, Arthritis, Asthma, CKD, Thoracic compression fracture, COPD, Depression, Diabetes mellitus, Dysphagia, GERD, Esophageal ring, hyperlipidemia, hypertension, migraine, nephrolithiasis, premtaure ventricular contractions, restless legs syndrome.
Allergies: NKDA
Diagnostic Lab Data: Positive COVID test on 8/10/2021 using the Roche LIAT SARS assay platform using PCR or equivalent nucleic acid amplification technology.
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/14/2021 and 2/2/2021. Patient contacted physician office on 8/9/2021 stating had a positive COVID HOME test on 8/8/2021 with a three day history of sore throat, headache, congestion, coughing also noted to have oxygen level of 81 and fever of 101.9. Patient was retested on 8/10/2021 and was positive. Patient presented to ED on 8/10/2021 with complaints of shortness of breath. On presentation SpO2 100% on room air without significant tachypnea, but with mild bilateral wheezes. Patient received Imdevimab+casirivimab and was discharged home @ 1645. Patient presented back to ED at 2011 in respiratory distress with increased work of breathing, accessory muscle use, and transient hypoxia. Noted O2 sats of 74% on room air, and placed on high-flow nasal cannula. Patient improved rapidly overnight coming down to just 2 L NC by the following morning. Patient stated she felt better as well denying SOB, fevers or chills but reporting some cough. Patient O2 needs had decreased to 4 L on ambulation by 8/13. She was discharged on home with home O2 on 8/13. She was prescribed dexamethasone to complete a total of 10 days of therapy for COVID and cefdinir to complete 5 days of therapy for suspected overlying bacterial PNA. Patient presented to ED on 8/14/2021 due to shortness of breath. She was transferred to ICU 8/15 due to acute hypoxic respiratory failure due to COVID-19 pneumonia and found to have secondary bacterial pna. Patient returned to the floor in hosptial but subsequently bounced back to the ICU 8/25 and intubated 8/26. Patient continued to deteriorate and palliative care was consulted. 8/31 decision was made by family to pursue DNR/AND. Patient passed away peacefully at 8:54PM on 8/31/2021.


VAERS ID: 1685685 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-12
Onset:2021-08-16
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Death, General physical health deterioration, Hypoxia, Pulmonary fibrosis, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-03
   Days after onset: 18
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tivicay 50 mg QD, Descovy 200mg/25 mg QD, Prezcobix 800mg/150 mg QD, Bactrim 800mg/160 mg QD, Pravastatin 10 mg QD, Dulera 200mcg/50 mcg BID, Cyanocobalamin 100 mg QD, Albuterol PRN.
Current Illness:
Preexisting Conditions: HIV Infection, Pulmonary fibrosis
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 1/14/2021 and 2/12/2021. Presented to ED on 8/16/2021 with complaints of worsening hypoxia after a positive COVID test the previous week from an outside facility. Symptom onset was 8/11/2021. Patient has been on 5L NC at baseline for pulmonary fibrosis. Patient treated with dexamethasone, remdesivir, and highflow oxygen. Patient initially improved after 5 days of remdesivir and 10 days of dexamethasone, but hypoxia worsened starting on 8/30/2021. On 9/3/2021 patient rapidly deteriorated, and expired at 1545 on 9/3/2021.


VAERS ID: 1685687 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-30
Onset:2021-08-17
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure abnormal, COVID-19, Cough, Death, Decreased appetite, Diabetic ketoacidosis, Dialysis, Diarrhoea, Endotracheal intubation, General physical health deterioration, Hypoxia, Nausea, Prone position, Pyrexia, Renal impairment, Respiratory acidosis, Resuscitation, SARS-CoV-2 test positive, Septic shock, Tachycardia, Urine output decreased, Vascular catheterisation, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Toxic-septic shock conditions (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg QD, Atorvastatin 40 mg QD, Cholecalciferol 1000 units BID, Cyanocobalamin 100 mcg QD, Fish Oil BID, Glimepiride 4 mg BID, Hydralazine 50 mg TID, Insulin aspart 20 units TID, Insulin glargine 30 units QD, Isosorbide dinitrate 2
Current Illness:
Preexisting Conditions: Anemia of Chronic Disease, BPH, Chronic diastolic CHF, CHronic gout without tophus, Chronic ulcer of toe (left foot), Chronic venous insufficiency, CKD stage 3, CAD involving native artery of transplanted heart without angina pectoris, diabetic peripheral neuropathy associated with type 2 DM, Essential hypertension, H/O depression, H/O heart transplant, H/O nephrolithiasis, H/O shingles, hyperlipidemia, long-term immunosuppression, metabolic bone disease, obesity, Obstructive sleep apnea on CPAP, primary urethral papillary carcinoma.
Allergies: Gabapentin (altered mental status)
Diagnostic Lab Data: Positive COVID Tests on 8/17 and 8/18 .
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/7/2021 and 4/30/2021. Presented to ED on 8/17/2021 with cough, nausea, vomiting, diarrhea fever of 102, loss of appetite, and decreased UOP. Treated initially for DKA, and placed on HFNC. DKA resolved, and transitioned off insulin gtt 8/21. Due to increasing oxygen requirements, patient intubated on 8/23, and subsequently required proning. Developed septic shock, requiring norepinephrine and vasopressin gtt. Worsening renal function prompted Vascath placement and initiation of dialysis 8/29. Patient continued to deteriorate clinically, requiring the addition of epinephrine for blood pressure support, and worsening respiratory acidosis and hypoxemia. He developed wide complex tachycardia requiring 1 shock, after which family was called for goals of care discussion. Transitioned patient to comfort care, and he expired shortly thereafter.


VAERS ID: 1685693 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-15
Onset:2021-08-16
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood urine present, COVID-19, Chills, Cough, Culture urine positive, Death, Escherichia test positive, Feeling cold, Nephrolithiasis, Nephrostomy, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Respiratory failure (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: 2021-09-01
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg Q6H PRN, Allopurinol 100 mg QD, Amlodipine 10 mg QD, Cholecalciferol 1000 units QD, Lomotil QID PRN, Ferrous sulfate 325 mg QD, Loperamide 2 mg TID PRN, Metoprolol 50 mg BID, Sevelamer 800 mg TID, Sodium bicarbonate 5 g
Current Illness:
Preexisting Conditions: Benign prostate hyperplasia, , bilateral macular degeneration, bilateral sensorineural hearing loss, chronic gout with tophus, chronic respiratory failure with hypoxia due to obstructive sleep apnea, chronic kidney disease stage 3, depression with anxiety, essential hypertension, generalized osteoarthritis of multiple sites, H/O calcium pyrophosphate deposition disease, H/O prostate cancer, H/O Clostridium difficile colitis (3/2020), H/O of left nephrectomy for large nonfunctioning kidney, H/O of nonmelanoma skin cancer, Iron deficiency anemia, Left lower lobe pulmonary nodules, obesity, Primary insomnia, H/O renal cell cancer (right kidney).
Allergies: NKDA
Diagnostic Lab Data: COVID Positive Test 8/18/2021 using the Hologic Panther System Platform using PCR or equivalent nucleic acid amplification technology. Urine culture = E. coli ESBL.
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/18/2021 and 4/15/2021. Presented to ED on 8/16/2021 with complaints of weakness and fever over the past day. Patient''s nephrostomy tube was changed two weeks prior for an infected kidney stone and patient just started noticing blood in his foley bag the morning of presenting to the ED. Admitted for UTI. On 8/17/2021 patient expressed concern for COVID status since family at home is COVID positive. Patient has mild cough but feels it is chronic at baseline. Patient tested positive for COVID on 8/18/2021 and spiked a fever that afternoon. On 8/19/2021 patient reported feeling cold and having chills overnight as well as dry cough, but denies shortness of breath. On 8/20/2021 patients SPO2 dropped (86-88%) on 6L O2. Patient was placed on NRB with 96% sats. On 8/21 patient on HFNC with escalating oxygen requirements, patient started on dexamethasone. On 8/25 patient experienced destauration to 87% while on 6L NC. On 8/30/2021 patient wished to discuss comfort care. On 8/31/2021 patient was transitioned to inpatient hospice, and patient expired on 9/1/2021.


VAERS ID: 1685705 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-08-25
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bacteraemia, Bacterial test, COVID-19, Chills, Cough, Death, Diarrhoea, Endotracheal intubation, Fatigue, Haemodialysis, Hypoxia, Mechanical ventilation, Myalgia, Pyrexia, Renal impairment, SARS-CoV-2 test positive, Sepsis, Septic shock, Staphylococcus test positive, Ultrasound kidney normal, Vascular catheterisation
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Toxic-septic shock conditions (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-31
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg QD, Aspirin 81 mg QD, Atorvastatin 40 mg QD, Calcium Acetate QD, Carvedilol 25 mg BID, Cetririzine 10 mg QD PRN, Clopidogrel 75 mg QD, Ergocalciferol 50,000 units QWeek, Fluticasone nasal BID, Insulin aspart 28 units TID, La
Current Illness:
Preexisting Conditions: Type 2 DM, HTN, hyperlipidemia, Obesity, PVD, CKD, GERD, OSA on CPAP, Hypothyroidism.
Allergies: Lisinopril (Cough), Potassium (Nausea)
Diagnostic Lab Data: Covid Positive Test on 8/25/2021 using Roche LIAT SARS Assay platform using PCR or equivalent nucleic acid amplification technology.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course. Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes. On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic. On 8/31, the patient''s MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21.


VAERS ID: 1686251 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-31
Onset:2021-09-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Injection site pruritus
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: patients daughter reported to us that the patient died on 9/4 or 9/5. the patient was otherwise healthy. the patient told her daughter that her arm itched some at the injection site. the family is not doing an autopsy


VAERS ID: 1688648 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-20
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Sick for 3 days (as if he had the virus again), 68 y/o, 03/21/21, Moderna Covid-19, 1st dose
Other Medications: Coreg, Aspirin, Symbicort, Levimir, Lyrica, Humolog
Current Illness: Long hauler symptoms from Covid-19 infection in March 2020
Preexisting Conditions: CAD, CKD, DM2, Hyperlipidemia, mycocardial infarction
Allergies:
Diagnostic Lab Data: Completed at the hospital on 04/19/21 to 04/20/21
CDC Split Type:

Write-up: Death


VAERS ID: 907575 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2020505569

Write-up: Diarrhoea; This is a spontaneous report from a contactable other healthcare professional via Agency and downloaded from the Regulatory Authority GB-MHRA-WEBCOVID-20201212222117, Safety Report Unique Identifier GB-MHRA-ADR 24542707 and EU-EC-10007191252. An elderly patient of an unspecified gender received bnt162b2 (batch/lot number not provided), via an unspecified route of administration in 2020 at single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced diarrhoea in 2020. The patient died due to diarrhoea on 10Dec2020. It was not reported if an autopsy was performed. No follow-up attempts are possible. Information on the lot/batch number not obtainable. No further information is expected.; Reported Cause(s) of Death: diarrhoea


VAERS ID: 908245 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-13
Onset:2020-12-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Circulatory collapse, Death
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), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-13
   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: GBPFIZER INC2020505572

Write-up: Asystole; Circulatory collapse; This is a spontaneous report from a contactable pharmacist received from Agency and downloaded from the Regulatory Authority-WEB GB-MHRA-WEBCOVID-20201214111558, Safety Report Unique Identifier GB-MHRA-ADR 24542972 and EU-EC-10007191566 received via Regulatory Authority. An adult female patient received bnt162b2 (batch/lot number not provided), via an unspecified route of administration on 13Dec2020 at single dose for COVID-19 vaccination. The patient''s medical history was not reported. Concomitant medication included sildenafil, acetylsalicylic acid, allopurinol, levothyroxine, spironolactone, amiloride hydrochloride, furosemide and desogestrel. The patient experienced asystole on 13Dec2020, circulatory collapse on 13Dec2020. The patient died due to asystole and circulatory collapse on 13Dec2020. It was not reported if an autopsy was performed. No follow-up attempts are possible. Information about batch number is not obtainable. No further information is expected.; Reported Cause(s) of Death: circulatory collapse; Asystole


VAERS ID: 913881 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:2020-12-27
Onset:2020-12-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-29
   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: CYPFIZER INC2020517293

Write-up: the patient died; This is a spontaneous report from a contactable consumer through a Pfizer employee. A 98-99 years old patient of an unspecified gender received bnt162b2 (COMIRNATY), via an unspecified route of administration possibly on 27Dec2020 at single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient died on 29Dec2020. Event details: The Pfizer employee was informed, by a member of the Covid vaccine team at the ministry of health, that an elderly person 98-99 years old, who used to stay in an elderly home, who also had other serious diseases and received the vaccine possibly on 27Dec2020, had died this morning (29Dec2020). As it was mentioned to the Pfizer employee, they were ''sure'' that the cause of death did not related to the vaccine. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: unknown cause of death


VAERS ID: 918721 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac death, Loss of consciousness, Malaise
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), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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: 2020-12-28
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer (NOS); Heart disease, unspecified; Heart failure, unspecified
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2020517122

Write-up: cardiac arrest; heart failure; did not feel well, lost consciousness and died; did not feel well, lost consciousness and died; This is a spontaneous report from a contactable consumer. A 75-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 28Dec2020 08:30 at single dose for covid-19 immunisation. Medical history included suffered from the past from heart attacks, active heart disease, malignant disease. The patient''s concomitant medications were not reported. A man of 75 years old, who suffers from many different background diseases, died (this morning 28Dec2020) from cardiac arrest, two hours after he received the injection. The man received the injection at 8.30am, and after he was feeling okay he was released to go home. After a while when he was home he did not feel well, lost consciousness and died, and he was pronounced dead from heart failure. The patient died on 28Dec2020. It was not reported if an autopsy was performed. The outcome of the event cardiac arrest and heart failure was fatal while the outcome of the other events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: Linked Report(s) : IL-PFIZER INC-2020517177 same reporter, same vaccine, reporting similar events in different patients.; Reported Cause(s) of Death: heart failure; cardiac arrest


VAERS ID: 918722 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-24
Onset:2020-12-28
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4175 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-28
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bladder tumor resection; Emphysema; Heavy smoker (for almost 50 years); Schizophrenia
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2020517177

Write-up: found dead in his bed; This is a spontaneous report from a contactable healthcare professional received via the Ministry of Health department of epidemiology. The department of epidemiology reported similar events for two patients. This is the second of two reports. A 61-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EK4175), via an unspecified route of administration on 24Dec2020 as a single dose for COVID-19 immunization. Medical history included schizophrenia, very heavy smoker for almost 50 years, emphysema, and tumor resection in the bladder. The patient''s concomitant medications were not reported. On 28Dec2020, the patient was found dead in his bed. It was reported that the patient did not have any complaints in the days following the vaccination. Then, on 28Dec2020, the patient was found dead. The cause of death was unknown. It was not reported if an autopsy was performed.; Sender''s Comments: A reasonable possibility that the event unknown cause of death is related to vaccination with BNT162B2 cannot be completely excluded until further information regarding clinical course and death cause is provided. Of note, the patient did not have any complaints in the days following the vaccination. The case was confounded by the patient''s underlying conditions. 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.,Linked Report(s) : IL-PFIZER INC-2020517122 same reporter, same vaccine, reporting similar events in different patients.; Reported Cause(s) of Death: found dead in his bed


VAERS ID: 918727 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac death, Illness
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (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: SEPFIZER INC2020519895

Write-up: died the day after receiving the first injection of vaccine against Covid-19 in suspected cardiac arrest; This is a spontaneous report from a web page with a contactable physician as publisher. A multi-sick, elderly patient of an unspecified gender received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for covid vaccination. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient died the day after vaccination of a suspected heart stop. The patient died the day after receiving the first injection of vaccine against covid-19. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about LOT/batch number cannot be obtained.; Sender''s Comments: The information available in this report is limited and does not allow a medically meaningful assessment of the case. In particular the following relevant information is not available: complete medical history and complete demographics, treatment dates and dose, concomitant medications (if any), event descriptors, autopsy report. 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: suspected heart stop


VAERS ID: 920891 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-29
Onset:2020-12-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-31
   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: Medical History/Concurrent Conditions: Upper respiratory tract infection; Weakness
Allergies:
Diagnostic Lab Data: Test Date: 20201225; Test Name: COVID-test; Test Result: Negative ; Test Date: 20201231; Test Name: Vital signs; Result Unstructured Data: Test Result:found without vital signs during routine control
CDC Split Type: DEPFIZER INC2021000080

Write-up: deceased on 31Dec2020 with no previous side effect; This is a spontaneous report from a contactable physician via "Pfizer". An 87-year-old female patient received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: "not known because vaccination team vaccinated at care home"), via an unspecified route of administration on 29Dec2020 at a single dose for COVID-19 immunization. The patient''s medical history included upper respiratory tract infection, changing patient weakness; both from an unknown date and unknown if ongoing. Concomitant medications were not reported. The patient experienced: deceased on 31Dec2020 with no previous side effect; which resulted in death on 31Dec2020. The clinical course was reported as follows: the patient received the first dose of the PFIZER-BIONTECH COVID-19 MRNA VACCINE on 29Dec2020; and the patient was deceased on 31Dec2020 with no previous side effect. The patient received the vaccination with a negative COVID-test on 25Dec2020; "in case of upper respiratory tract infection and changing patient weakness". The physician reported that "after good breakfast at 09:13 found without vital signs during routine control." The clinical outcome of the event was fatal. The patient died on 31Dec2020 due to unknown cause of death. It was unknown if an autopsy was performed. The batch/lot numbers for the vaccine, PFIZER-BIONTECH COVID-19 MRNA VACCINE, were not provided and will be requested during follow up.; Sender''s Comments: The limited information available does not allow a meaningful assessment by the company. The advance old patient had upper respiratory tract infection, changing patient weakness; further information such as complete medical history, concomitant treatments, particularly death cause and autopsy results are needed for fully medical assessment. 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: deceased on 31Dec2020 with no previous side effect


VAERS ID: 923219 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Sudden death, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: PTPFIZER INC2021002036

Write-up: Sudden death; This is a spontaneous report from a contactable physician and consumer. A 41-year-old female patient received the first dose of BNT162B2 (COMIRNATY; Lot Number: UNKNOWN), via an unspecified route of administration on 30Dec2020 at 0.3 mL single dose for COVID-19 immunisation. Medical history included hypertension. The patient''s concomitant medications were not reported. On 01Jan2021, the patient experienced sudden death. The clinical course was as follows: The patient didn''t experience any adverse event at the moment of inoculation with COVID-19 vaccine or the following days. On 01Jan2021, at lunch time, two days after receiving the vaccine, the patient was found unresponsive in her bed by her partner. The cause of death was unknown. It was reported that an autopsy would be performed in the next days; the results were not yet available. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: The reported information is limited and does not allow a meaningful assessment of the case. It will be reassessed upon receipt of follow up information. 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: Sudden death


VAERS ID: 925616 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-30
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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: 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: Medical History/Concurrent Conditions: Asthma; Overweight
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2021000681

Write-up: cardiac arrest; This is a spontaneous report from a contactable physician. A 64-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 30Dec2020 as single dose for covid-19 immunization. Medical history included asthma and a little overweight from an unknown date. The patient''s concomitant medications were not reported. The patient experienced cardiac arrest on an unspecified date, which was serious as it lead to death. The patient died on an unspecified date. It was not reported if an autopsy was performed. This batch/lot number is not available despite the follow-up attempts made. No further information is expected.; Sender''s Comments: The reported information is limited and does not allow a meaningful assessment of the case. It will be reassessed upon receipt of follow up information. 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: cardiac arrest


VAERS ID: 928992 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-18
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0553 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Condition aggravated, Death, Malaise
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-20
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: Atrial fibrillation; Diabetes; Frailty; Hypothyroidism; Osteoporosis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021003922

Write-up: Atrial fibrillation; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority. The regulatory authority report number is GB-MHRA-EYC 00236011. An 87-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number EJ0553), intramuscular on 18Dec2020 at 0.3 mL, single for covid-19 immunization. Medical history included ongoing hypothyroidism, ongoing diabetes, ongoing atrial fibrillation, ongoing frailty and, ongoing osteoporosis, all from unknown dates. Concomitant medication included prednisolone (MANUFACTURER UNKNOWN), levothyroxine (MANUFACTURER UNKNOWN), salbutamol (MANUFACTURER UNKNOWN), omeprazole (MANUFACTURER UNKNOWN), doxycycline (MANUFACTURER UNKNOWN). The patient experienced atrial fibrillation on an unspecified date, which was serious as it was medically significant, involved hospitalization and lead to death. Clinical course was as follows: the patient was vaccinated. Consent was obtained and a pre immunization checklist was completed. She was observed following the administration of the vaccine, and no adverse effects were noted. She returned home. She became unwell and was admitted to hospital approximately 24 hours later. The patient was admitted to the hospital 24 hours following the vaccination, and subsequently died later, while in the hospital. The full clinical details were unknown, but the diagnosis from Accident & Emergency was atrial fibrillation. It is not clear if this had any relation to the vaccine that was administered, but could not be excluded, per the reporter. The patient died on 20Dec2020. It was not reported if an autopsy was performed. No follow-up activities are possible. No further information is expected.; Reported Cause(s) of Death: Atrial fibrillation


VAERS ID: 929016 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1677 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Diarrhoea, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-30
   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: INFLUENZA VIRUS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Delirium (History of); Dementia; Urinary tract infection (History of)
Allergies:
Diagnostic Lab Data: Test Date: 20201208; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative
CDC Split Type: GBPFIZER INC2021009768

Write-up: Death; Loose stools; Vomited; This is a spontaneous report from a contactable other healthcare professional by Pfizer from the Regulatory Agency (UK-MHRA). The regulatory authority report number is GB-MHRA-WEBCOVID-20201230164020. An elderly female patient received BNT162B2 (COVID-19 MRNA VACCINE BIONTECH, Batch: EJ1677, Expiration date: Feb2021) via an unspecified route on 29Dec2020 at single dose for Covid-19 vaccination. Medical history included dementia and a history of urinary tract infection and delirium, all from an unknown date and unknown of ongoing. Concomitant medication included influenza vaccine (INFLUENZA VIRUS, Batch: 4924B1A) for influenza immunization. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. No known allergies. The patient had not tested positive for COVID-19 since having the vaccine. On the 29Dec2020 the patient experienced loose stools and vomited. The patient underwent lab tests and procedures which included COVID-19 virus test: no -negative on 08Dec2020. The patient died on the 30Dec2020 at 11:25 am in the morning. It was unknown if a postmortem was going to be carried out, after talking to the general practice surgery they advised that the general practitioner was only passed notification of the patient''s death that afternoon (04Jan2021). It was advised that they may go to the coroner but couldn''t give a definitive answer until the general practitioner had looked at the notification. It was not reported if an autopsy was performed. No follow up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Death


VAERS ID: 929023 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-19
Onset:2020-12-24
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0553-V0003 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Death, Dyspnoea, Malaise, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-28
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ; ASPIRIN (E.C.); ; ; FLIXONASE; ; FULTIUM D3; ; ; ; NOVORAPID; ; LEVEMIR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cerebrovascular accident; Coronary angiogram (nov); Diabetes; Heart failure; Hypertension
Allergies:
Diagnostic Lab Data: Test Name: COVID test score; Result Unstructured Data: Test Result:unknown results
CDC Split Type: GBPFIZER INC2021009826

Write-up: possible myocardial infarction; Dyspnoea; unwell; Cough; This is a spontaneous report from a contactable physician downloaded from the Regulatory Agency. Regulatory authority GB-MHRA-WEBCOVID-20210105105739, other manufacturer number is GB-MHRA-ADR 24556743. A 76-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EJ0553-v0003), via unspecified route of administration on 19Dec2020 at single dose for COVID-19 vaccination. Medical history included diabetes mellitus, angiocardiogram, cardiac failure, hypertension, all from unspecified date and unknown if ongoing and cerebrovascular accident from 2001 and unknown if ongoing. Patient has not had symptoms associated with COVID-19 Patient has not been tested/or has had an inconclusive test for COVID-19. Unsure if patient is enrolled in clinical trial. Concomitant medication included amlodipine, acetylsalicylic acid (ASPIRIN (E.C.)), atorvastatin, bisoprolol, fluticasone propionate (FLIXONASE), folic acid, colecalciferol (FULTIUM-D3), furosemide, latanoprost, levothyroxine, insulin aspart (NOVORAPID), ramipril and insulin detemir (LEVEMIR). On 24Dec2020, the patient experienced a cough. It was noted that the patient''s son and wife had already been coughing but no coronavirus tests had been done at the time of this event. On an unknown date, the patient experienced dyspnoea. It was noted that the he had become increasingly short of breath and unwell. On 28Dec2020, the patient died. It was noted to be a possible myocardial infarction. The patients COVID test score was unknown. The autopsy was awaited at the time of this report. The outcome of the event possible myocardial infarction was fatal, while other events were unknown. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: possible myocardial infarction


VAERS ID: 929027 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-25
Onset:2020-12-01
Submitted: 0000-00-00
Entered: 2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4175 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Death, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-28
   Days after onset: 27
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: Medical History/Concurrent Conditions: Alcohol use; Aortic stenosis; Atrial fibrillation; Carotid artery stenosis; Chemotherapy; COPD; Diabetes; Diabetic nephropathy; Diabetic neuropathy; Diabetic retinopathy; DVT; Hepatitis; Hodgkin''s lymphoma; Mobility decreased; Smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2021009751

Write-up: At night they found him lifeless. Probably following acute MI; pain in the arm and swelling in the arm of vaccination; pain in the arm and swelling in the arm of vaccination; This is a spontaneous report from a contactable other healthcare professional via Division of Health. The other healthcare professional reported similar events for three patients. This is the second of three reports. A male patient of an unspecified age received BNT162B2 (lot# EK4175), via an unspecified route of administration on 25Dec2020 at single dose for Covid-19 immunisation. Medical history included chronic obstructive pulmonary disease (COPD) with smoking background, atrial fibrillation, aortic stenosis, diabetes with damage to all target organs (nephropathy, retinopathy, neuropathy), carotid stenosis, deep vein thrombosis (DVT) history, history of alcohol use with hepatitis, history of Hodgkin''s lymphoma after successful chemotherapy treatment, got around on a scooter. The patient''s concomitant medications were not reported. The patient was vaccinated on 25Dec2020 and passed away at home on 28Dec2020. Before his death, according to his daughter, he complained about pain in the arm and swelling in the arm of vaccination on an unspecified date of Dec2020. At night they found him lifeless. Probably following acute myocardial infarction (MI). The outcome of pain in the arm and swelling in the arm of vaccination was unknown, acute MI was fatal. It was not reported if an autopsy was performed. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Fatal acute myocardial infarction is more likely attributed to the patient underlying medical conditions including vascular stenosis and diabetes with complications. 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,Linked Report(s) : IL-PFIZER INC-2020519349 same reporter/product, similar event, different patient;IL-PFIZER INC-2021009752 same reporter/product, similar event, different patient; Reported Cause(s) of Death: acute MI


VAERS ID: 929028 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Endotracheal intubation, Pleural effusion, Pyrexia, Respiratory distress, Sepsis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Respiratory failure (narrow), 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: 2021-01-04
   Days after onset: 3
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: Medical History/Concurrent Conditions: Bladder cancer; Blood pressure abnormal; Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2021009752

Write-up: SEPSIS; respiratory distress; PLEURAL EFFUSION; This is a spontaneous report received from other healthcare professional via the Division of epidemiology of the Ministry of Health. The other healthcare professional reported similar events for three patients. This is the third of three reports. A 91-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 30Dec2020 at single dose for covid-19 immunisation. Medical history included known background of blood pressure disease, diabetes, malignant bladder from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. Patient was received at the emergency room 3 days after receiving the corona vaccine in Jan2021, with fever, vomiting more than 40 times, in respiratory distress, was hospitalized in internal medicine department with sepsis diagnosis due to respiratory distress and pleural effusion, intubated, his condition was serious, patient passed away on 04Jan2021. Cause of death was reported as sepsis, respiratory distress and pleural effusion. It was not reported if an autopsy was performed. Follow-up attempts are completed. No further information is expected. Information about batch/lot number cannot be obtained.; Sender''s Comments: Based on the information currently provided, the fatal events sepsis, respiratory distress and pleural effusion are more likely attributed to intercurrent infectious conditions associated with the advanced old patient underlying diseases . 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.,Linked Report(s) : IL-PFIZER INC-2020519349 same reporter, product, similar event, different patient;IL-PFIZER INC-2021009751 same reporter, product, similar event, different patient; Reported Cause(s) of Death: SEPSIS; respiratory distress; PLEURAL EFFUSION


VAERS ID: 933230 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-20
Onset:2020-12-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-21
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiac disorder; Lung disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021004572

Write-up: Death within 24 hours after dose; This is a spontaneous report from a contactable consumer downloaded from the regulatory authority (GB-MHRA-EYC 00236003 and GB-MHRA-ADR 24545815). A 78-year-old male patient received BNT162B2 (COMIRNATY), via an unspecified route of administration, on 20Dec2020 at 16:00 as a single dose for COVID-19 immunization. Medical history included cardiac disease and lung disease. The patient had no known allergies. Concomitant medications included an unspecified hypertensive taken for hypertension, an unspecified drug for ischaemic heart disease, and an unspecified drug for chronic obstructive pulmonary disease (COPD). The patient experienced death within 24 hours after dose on 21Dec2020. The event was reported as fatal. The clinical course was reported as follows: The patient was observed for 15 minutes after the dose was given and had no side effects. In the evening, the patient felt well. The patient received the vaccination as he was a high risk patient, elderly, and with a background of cardiac and lung disease. The clinical outcome of death within 24 hours after dose was fatal. The patient died on 21Dec2020. The cause of death was unexplained. It was unknown if an autopsy was performed. The reporter assessed the causality between the vaccination and death as unlikely. No follow-up attempts possible; information on lot and batch numbers cannot be obtained.; Reported Cause(s) of Death: Death unexplained


VAERS ID: 933232 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-17
Onset:2020-12-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Dizziness, Epistaxis, Haematemesis, Haemoptysis, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Vestibular disorders (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-20
   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: ; VENTOLINE [SALBUTAMOL SULFATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Vitamin D3 deficiency
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021004563

Write-up: Death; Head ache and dizziness; Head ache and dizziness; Spitting blood; Vomiting blood; Nose bleed; This is a spontaneous report a contactable consumer downloaded from the Regulatory Authority(GB-MHRA-WEBCOVID-20201220100831 and GB-MHRA-ADR 24545199). A male patient of an unspecified age received BNT162B2 (COMIRNATY), via an unspecified route of administration, on 17Dec2020 as a single dose for COVID-19 immunisation. Medical history included vitamin D3 deficiency and asthma. Concomitant medications included colecalciferol (MANUFACTURER UNKNOWN) for vitamin deficiency and salbutamol sulfate (VENTOLINE) for asthma. The patient experienced nose bleed on 17Dec2020, head ache and dizziness, spitting blood, and vomiting blood on 18Dec2020, and death on 20Dec2020. All of the events were reported as fatal. It was reported that a healthcare professional advised the patient to take unspecified pain medication after explaining mild and strong side effects to help with pain. The patient underwent lab tests and procedures which included COVID-19 virus test: No - negative COVID-19 test on an unspecified date. Therapeutic measures were taken as a result of nose bleed, head ache and dizziness, spitting blood, and vomiting blood as aforementioned. The clinical outcome of nose bleed, head ache and dizziness, spitting blood, vomiting blood, and death was fatal. The patient died on 20Dec2020. The cause of death was unexplained. It was not reported if an autopsy was performed. It was also reported that since the vaccination, the patient had not been tested positive for COVID-19. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Death unexplained


VAERS ID: 934465 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-28
Onset:2020-12-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4237 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Circulatory collapse, Death
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-29
   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: Medical History/Concurrent Conditions: Atrial fibrillation; Cardiac disorder; Cardiac pacemaker insertion; Dementia; Heart failure; Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20201229; Test Name: pulse; Result Unstructured Data: Test Result:no pulse
CDC Split Type: ILPFIZER INC2020519349

Write-up: patient died after collapsing in his home several hours after he received the vaccine; patient died after collapsing in his home several hours after he received the vaccine; The initial case was missing the following minimum criteria: the reporter does not have first-hand knowledge of the reported events and was not identifiable. Upon receipt of follow-up information on 06Jan2021, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable healthcare professional via regulatory Authority. The regulatory authority reported similar events for three patients. This is the first of three reports. An 88-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EK4237), via an unspecified route of administration on 28Dec2020 as a single dose for COVID-19 immunization. Medical history included dementia, cardiac background with pacemaker, atrial fibrillation, heart failure, and penicillin allergy. The patient was not allergic to polyethylene glycol. The patient''s concomitant medications were not reported. On 29Dec2020, the patient died after collapsing in his home several hours after he received the vaccine. Outcome of collapsing was not recovered. The patient had no pulse when he arrived at the hospital. It was not reported if an autopsy was performed. The cause of death was unknown. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: The advance old patient had underlying cardiac background with pacemaker, atrial fibrillation and heart failure, therefore the pre-existing cardiovascular medical conditions more likely provide explanations for collapsing lead to the patient death. More information especially death cause and autopsy results are needed for further meaningful assessment. 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.,Linked Report(s) : IL-PFIZER INC-2021009752 same reporter, product, similar event, different patient;IL-PFIZER INC-2021009751 same reporter, product, similar event, different patient; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 934760 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021006905

Write-up: Death in connection with the vaccination and/or Covid19 disease / positivity; Death in connection with the vaccination and/or Covid19 disease / positivity; This is a spontaneous report from a contactable physician. This physician reported similar events for two patients. This is the second of two reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was reported 2 deceased were autopsied, death in connection with the vaccination or Covid19 disease / positivity.; Sender''s Comments: The information currently provided is too limited to make a meaningful medical assessment hence, the events are conservatively assessed as related to the suspect drug BNT162B2 until further 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 RAs, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : DE-PFIZER INC-2021006738 same reporter, same product, same event, different patient; Reported Cause(s) of Death: Death in connection with the vaccination and/or Covid19 disease / positivity; Death in connection with the vaccination and/or Covid19 disease / positivity


VAERS ID: 934763 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: ELIQUIS;
Current Illness: Atrial fibrillation; Dementia; Depression; Obstipation (Periodic treated)
Preexisting Conditions: Medical History/Concurrent Conditions: Tibia fracture (conservative treatment)
Allergies:
Diagnostic Lab Data:
CDC Split Type: DKPFIZER INC2021013445

Write-up: Sudden death; This is a spontaneous report downloaded from the regulatory authority DK-DKMA-WBS-0028211. Report was received from a contactable nurse via regulatory authority. A 94-years-old female patient received BNT162B2 (COMIRNATY) (Lot # EJ6797, exp date 30Apr2021), via intramuscular on 30Dec2020 at first single dose for covid-19 immunization. Medical history included ongoing periodic obstipation (periodic treated), ongoing dementia, ongoing atrial fibrillation, ongoing depression, tibia fracture from 01Nov2020 (treated conservatively). Concomitant medication included apixaban (ELIQUIS) from 09Apr2018 to unknown date for atrial fibrillation, sertraline from 20Jun2018 to unknown date for depression. The patient had not received BNT162B2 before. The patient experienced sudden death on 01Jan2021. There was no immediate illness until the time of vaccination and the nurse described that she "seemed like herself and fresh". The ADRs were by the reporter reported as fatal. Reported cause of death: Unknown caused of death, sudden death. No treatment due to the death was described. There is no information regarding test results. An autopsy was not performed. Causality: The doctor who issued the death certificate does not suspect that it is the COVID-19 vaccine that is the cause of her death. She slept quietly in, and was old. Due to reporting obligation this case is reported. If the regulatory authority receives supplemental significant information regarding this case the case will be re-submitted.; Reported Cause(s) of Death: Sudden death; Unknown cause of death


VAERS ID: 934764 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2020-12-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, C-reactive protein normal, Chronic obstructive pulmonary disease, Condition aggravated, Death, Dyspnoea, Fibrin D dimer normal, Fluid balance assessment, Forced expiratory volume decreased, Hepatic enzyme, Oxygen saturation decreased, PCO2 increased, Respiratory failure, Restlessness
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (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), Dementia (broad), Akathisia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-03
   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: PREDNISOLON ACTAVIS; IPRAMOL; LYSANTIN; QUETIAPIN ACCORD; VENTOLINE [SALBUTAMOL SULFATE]; PARACETAMOL ORIFARM; QUETIAPIN ARROW; BUPRENORPHINE/NALOXONE MYLAN; XEPLION; TRELEGY ELLIPTA; PHENERGAN [PROMETHAZINE HYDROCHLORIDE]
Current Illness: Alcohol abuse chronic; Anxiety; Chronic obstructive airways disease exacerbated; Dyspnoea; Hallucination; Hypoxic (Hypoxic down to 60 %); Insomnia; Opioid abuse; Pain; Paranoid schizophrenia; Psychosis; Tobacco abuse; Treatment noncompliance
Preexisting Conditions: Medical History/Concurrent Conditions: Amphetamine abuse; Chronic obstructive airways disease exacerbated
Allergies:
Diagnostic Lab Data: Test Name: C-reactive protein; Result Unstructured Data: Test Result:normal; Test Date: 20201227; Test Name: C-reactive protein; Result Unstructured Data: Test Result:16; Test Date: 20201231; Test Name: Fibrin D dimer; Result Unstructured Data: Test Result:Normal; Test Date: 20201227; Test Name: Fluid balance assessment; Result Unstructured Data: Test Result:Normal; Test Date: 2018; Test Name: FEV 1; Test Result: 37 %; Test Date: 20201227; Test Name: Hepatic enzyme; Result Unstructured Data: Test Result:Normal; Test Name: Oxygen saturation; Test Result: 64 %; Test Date: 20201220; Test Name: Oxygen saturation; Test Result: 60 %; Test Date: 20201227; Test Name: Oxygen saturation; Test Result: 58 %; Test Date: 20201231; Test Name: Oxygen saturation; Test Result: 62 %; Test Date: 20201231; Test Name: Oxygen saturation; Test Result: 35 %; Comments: in the ambulance; Test Date: 20201231; Test Name: Oxygen saturation; Test Result: 100 %; Comments: on oxygen-treatment; Test Date: 20210102; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:40-60 %; Comments: 12:47 pm; Test Date: 20210102; Test Name: Oxygen saturation; Test Result: 58 %; Comments: 09:00 am in the ambulance; Test Date: 20210102; Test Name: Oxygen saturation; Test Result: 30 %; Comments: 04:24 am; Test Date: 20210102; Test Name: Oxygen saturation; Test Result: 99 %; Comments: on oxygen-treatment; Test Name: PCO2; Result Unstructured Data: Test Result:up to 12.8 (Unit not specified); Test Name: PO2; Result Unstructured Data: Test Result:Down to 4.8 (Unit not specified)
CDC Split Type: DKPFIZER INC2021013449

Write-up: Hypoxic respiratory failure; Dyspnea exacerbated; This is a spontaneous report downloaded from the Medicines Agency (MA) WEB DK-DKMA-WBS-0028232. The report was received from a contactable physician via The Medicines Agency (MA). A 45-year-old male patient received BNT162B2 (COMIRNATY) (Lot #: EJ6797, Expiration Date: 30Apr2021), via intramuscular on 30Dec2020 at single dose for Covid-19 vaccination. Medical history included ongoing treatment noncompliance, ongoing alcohol abuse chronic, ongoing psychosis, dyspnoea from 20Dec2020 and ongoing, ongoing hallucination, ongoing tobacco abuse, ongoing paranoid schizophrenia, chronic obstructive airways disease exacerbated from Aug2020 and ongoing, chronic obstructive airways disease exacerbated from Nov2020 to an unknown date (not ongoing), hypoxic down to 60 % from 20Dec2020 and ongoing, Amphetamine abuse (not ongoing), ongoing pain, ongoing opioid abuse, ongoing anxiety, and ongoing insomnia. There is no information regarding past medication. Concomitant medication included prednisolone (PREDNISOLON ACTAVIS) from 20Nov2020 for Chronic obstructive airways disease, ipratropium bromide, salbutamol sulfate (IPRAMOL) from 20Nov2020 for Chronic obstructive airways disease exacerbated, orphenadrine hydrochloride (LYSANTIN) from 02Dec2019 to 03Jan2021 for Anxiety aggravated, quetiapine fumarate (QUETIAPIN ACCORD) from 16Dec2020 to 03Jan2021 for Psychiatric symptom, salbutamol sulfate (VENTOLINE) from 03Nov2018 for Chronic obstruct airways disease, paracetamol (PARACETAMOL ORIFARM) from 30Nov2020 to 03Jan2021 for Pain, quetiapine fumarate (QUETIAPIN ARROW) from 15Aug2020 to 03Jan2021 for Psychiatric symptom, buprenorphine hydrochloride, naloxone hydrochloride (BUPRENORPHINE/NALOXONE MYLAN) from 29Jun2020 to 03Jan2021 for Opioid abuse, paliperidone palmitate (XEPLION) from 19Dec2019 to 03Jan2021 for Psychiatric disorder prophylaxis, fluticasone furoate, umeclidinium bromide, vilanterol trifenatate (TRELEGY ELLIPTA) from 04Jul2019 to Jul2019 for Chronic obstruct airways disease, promethazine hydrochloride (PHENERGAN) from 24Sep2020 to 03Jan2021 for Insomnia. The patient experienced hypoxic respiratory failure on 31Dec2020, dyspnea exacerbated on 31Dec2020. Patient treatment: On the 31Dec2020 it is recorded that the patient did not want resuscitation in the event of cardiac arrest or respiratory treatment in the event of respiratory failure. Initially the patient did not want to transfer to somatic treatment. But because of anxiety after dyspnoea the patient got treatment with oxygen. On 01Jan2021 the patient denied again treatment despite clear indication for oxygen therapy and COPD exacerbations treatment with ipratropium bromide and salbutamol sulfate (IPRAMOL) and inhalations. On 02Jan2021 the patient received oxygen-treatment, but the patient did not want further somatic treatment. It was stated in the patient journal that the patient did not want treatment and that in the given situation there was nothing more to do. Therefore the patient was returned to department with palliative treatment in the form of oxygen, midazolam subcutaneous (S.C.) and morphine S.C. On the 03Jan2021 the patient''s respiration was calm. The patient was unreachable. At 14:00 he was restless and got palliative treatment with midazolam and morphine. The patient underwent lab tests and procedures which included c-reactive protein: normal on an unspecified date, 16 on 27Dec2020, fibrin D dimer: normal on 31Dec2020, fluid balance assessment: normal on 27Dec2020, forced expiratory volume (FEV 1): 37 % on 2018, hepatic enzyme: normal on 27Dec2020, oxygen saturation: 64 % on an unspecified date, 60 % on 20Dec2020, 58 % on 27Dec2020, 62 % on 31Dec2020, 35 % (in the ambulance) on 31Dec2020, 100 % (on oxygen-treatment) on 31Dec2020, 40-60% on 02Jan2021 12:47 pm, 58 % (in the ambulance) on 02Jan2021 09:00 am, 30 % on 02Jan2021 04:24 am, 99 % (on oxygen-treatment) on 02Jan2021, PCO2 up to 12.8 (Unit not specified) on an unspecified date, PO2 Down to 4.8 (Unit not specified) on an unspecified date. The patient died on 03Jan2021. An autopsy was not performed. The outcome of the events was fatal. Causality: The reporter assessed that even though the patient''s symptoms have occurred long before the vaccination, it can not be ruled out that the patient''s dyspnoea and hypoxia due to COPD have been aggravated by the vaccine. If the Medicines Agency receives supplemental significant information regarding this case the case will be re-submitted.; Reported Cause(s) of Death: Dyspnea exacerbated; Hypoxic respiratory failure


VAERS ID: 934765 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-03
Onset:2021-01-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Pulmonary oedema
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-04
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dementia with Lewy bodies; Hypertension; Osteoporosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: DKPFIZER INC2021013357

Write-up: Dyspnoea; suspected pulmonary edema; This is a spontaneous report downloaded from the regulatory authority DK-DKMA-WBS-0028304. Report was received from a contactable physician via from the regulatory authority. An 80-year-old female patient received bnt162b2 (COMIRNATY, lot EJ6797, expiration date 30Apr2021), intramuscularly on 03Jan2021 at single dose for covid-19 immunisation. Medical history included dementia with lewy bodies from an unknown date and unknown if ongoing, osteoporosis from an unknown date and unknown if ongoing, hypertension from an unknown date and unknown if ongoing. No previous drug was given. The patient''s concomitant medications were not reported. On 04Jan2021 around 12, approximately 25 hours after the vaccination the patient developed dyspnoea and pulmonary edema. 4 hours later she died. The patient did not experience any allergic symptoms. Events reported as dyspnoea and suspected pulmonary edema. The ADRs were by the reporter reported as fatal. No treatment due to the ADRs was reported. Reported cause of death was pulmonary edema. Outcome of event dyspnoea also reported as not recovered. There was no information regarding test results. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: Pulmonary edema; Dyspnoea


VAERS ID: 934781 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-15
Onset:2020-12-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-19
   Days after onset: 1
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: GBPFIZER INC2021009059

Write-up: Sepsis; Acute bronchopneumonia; This is a spontaneous report received from a contactable physician downloaded from the Regulatory Authority (GB-MHRA-EYC 00236063 and GB-MHRA-ADR 24546059). An 85-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscularly, on 15Dec2020 as a single dose for COVID-19 vaccination. The patient''s medical history was not reported. Concomitant medications included pregabalin (MANUFACTURER UNKNOWN), amitriptyline (MANUFACTURER UNKNOWN), amlodipine (MANUFACTURER UNKNOWN), candesartan (MANUFACTURER UNKNOWN), and levothyroxine (MANUFACTURER UNKNOWN). The patient experienced acute bronchopneumonia on 18Dec2020 and sepsis on an unspecified date. The events caused hospitalization and were reported as fatal. The clinical course was reported as follows: The patient was brought to the hospital by ambulance with severe sepsis and bronchopneumonia. She was resuscitated but unfortunately died shortly after arriving. The family reported that the patient received the coronavirus vaccine on 15Dec2020. It was reported that it is unclear from the family history whether she was unwell before she received the vaccine. The clinical outcome of acute bronchopneumonia and sepsis was fatal. The patient died on 19Dec2020. The cause of death was reported as acute bronchopneumonia and sepsis. It was not reported if an autopsy was performed. No follow-up attempts are possible; information on batch number cannot be obtained.; Sender''s Comments: The information available in this report is limited and does not allow a medically meaningful assessment of the case. In particular the following relevant information is not available: medical history, autopsy report.; Reported Cause(s) of Death: Sepsis; Acute bronchopneumonia


VAERS ID: 934782 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-18
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Death, Living in residential institution, Lower respiratory tract infection, Viral test negative
SMQs:, Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-22
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ; ; SODIUM VALPROATE; ; ;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Frailty (severely); Vascular dementia
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: Test Result:Settled - before giving vaccine Centigrade; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative - swab test
CDC Split Type: GBPFIZER INC2021009085

Write-up: Lower respiratory tract infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority GB-MHRA-EYC 00236087, Safety Report Unique Identifier: GB-MHRA-ADR 24546153 . A 83-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscularly on 18Dec2020 at single dose for covid-19 immunization. Medical history included vascular dementia from an unknown date and unknown if ongoing, severely frail from an unknown date and unknown if ongoing. This patient was severely frail as a result of vascular dementia and was a permanent nursing home resident. Concomitant medication included amoxicillin, doxycycline, sodium valproate, quetiapine, omeprazole, paracetamol. The patient experienced lower respiratory tract infection (LRTI) on an unspecified date. Patient died on 22Dec2020 within 5 days of receiving Covid vaccine, had been on antibiotics for LRTI for 2 days and had appeared to be improving, temperature was settled before vaccine was administered. She had a negative Covid swab at the onset of her symptoms. It would seem more likely that this patient died as a result of an evolving LRTI than as a result of receiving Covid vaccination. She was changed to amoxicillin 2 days before she died. The other outcome for Death was: Died 22Dec2020 but cause of death felt to be due to LRTI not vaccine. It was not reported if an autopsy was performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Sender''s Comments: The underlying predisposing condition (severely frail, lower respiratory tract infection) have been assessed to have played a major role toward the event.; Reported Cause(s) of Death: Lower respiratory tract infection


VAERS ID: 934826 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-20
Onset:2020-12-01
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0553 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-01
   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: Chronic obstructive pulmonary disease; Depression; Hypertension; Ischaemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021009370

Write-up: Death; This is a spontaneous report from a contactable consumer and a physician downloaded from the Regulatory Authority number GB-MHRA-WEBCOVID-20201222043330 and Safety Report Unique Identifier GB-MHRA-ADR 24545938. A 78-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, LOT: EJ0553) via an unspecified route of administration on 20Dec2020 around 15:45 at single dose in left upper arm for COVID-19 vaccination. The patient ongoing medical history included Depression, Hypertension, chronic obstructive pulmonary disease and ischaemic heart disease. Patient is not enrolled in clinical trial. Patient has not been tested/or has had an inconclusive test for COVID-19. Patient has not had symptoms associated with COVID-19. Concomitant medication included citalopram taken for Depression. The patient was taking unspecified concomitant medications for hypertension, chronic obstructive pulmonary disease (COPD) and ischaemic heart disease. The patient experienced death in Dec2020 (reported as in the evening of the 20Dec2020 or morning of 21Dec2020). Specifically, it was reported that the patient had the first dose of the vaccine at around 15:45 on 20Dec2020 and was observed for 15 minutes after with no side effects, the patient then left the site with family member. He was well that evening, he lived alone but spoke on the phone in the evening and felt well. On the 21Dec2020, after went to check on him and he was found in his bed passed away. When seeing the body, it was assumed that he had passed away in the evening of the 20Dec2020 or morning of 21Dec2020. Although unlikely, it was less than 24 hours after taking the vaccine. Patient has not tested positive for COVID-19 since having the vaccine. The patient was found dead in his flat the next day on 21Dec2020 by next of kin. He was dropped of home by family after the vaccination, he spoke to his family on the night after having the vaccination and told them he was feeling fine and was going to bed. He did not respond to telephone calls the next day (on Monday 21Dec2020) so the family went over to his flat and found he had passed away. The patient was registered at another surgery. Screening questions were asked, no contra indication found. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: death


VAERS ID: 934881 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Palliative care, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Dementia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: SEPFIZER INC2021009471

Write-up: Fever; This is a spontaneous report from a newsletter, from a contactable consumer (profession unspecified). Regulatory authority report number was not provided. An elderly female patient received bnt162b2 (COMIRNATY, Solution for injection, lot number and expiration date not provided), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. Medical history included ongoing dementia in a palliative state. The patient''s concomitant medications were not reported. The verbatim narrative was reported as follows: ''Status report on suspected side effects from vaccination against covid-19. The report on the second death was received on 05Jan2020. It concerns an elderly female with dementia in a palliative state. The female was vaccinated with Comirnaty, had fever on an unspecified date and passed away three days later. The information in the report is very brief and will seek additional information from the reporter. Currently, has no information on the female''s confirmed cause of death and there is no established causality with the vaccine.'' The patient died on an unspecified date. It was not reported if an autopsy was performed. The outcome of the event was fatal. No follow-up attempts are possible; information about LOT/batch number cannot be obtained.; Reported Cause(s) of Death: had fever and passed away three days later


VAERS ID: 934882 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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: Medical History/Concurrent Conditions: Heart attack
Allergies:
Diagnostic Lab Data:
CDC Split Type: SIPFIZER INC2021009992

Write-up: heart attack; This is a spontaneous report from a non-contactable consumer (discovered on news page and heard in news). An elderly female patient (elderly than 90-year old from home for elderly) received bnt162b2 (COMIRNATY) via unspecified route of administration on unspecified date at single dose for COVID-19 immunization (other details not reported). Medical history included heart attack. Concomitant medications were not reported. patient experienced heart attack six hours after vaccination that obviously occurred after repeated heart attack. It was stated that heart attack was not connected to the vaccination. There was no acute allergic reaction. Case was further investigated (independent committee) and confirmed the vaccination was not reason of death. Patient died from heart attack, it was unknown if autopsy was done. Information on batch number has been request.; Sender''s Comments: Fatal heart attack is not related to bnt162b2 use; the advanced old patient had pre-existing medical condition including previous episode of heart attack thus the underlying cardiovascular provided an explanation for the event onset.; Reported Cause(s) of Death: heart attack


VAERS ID: 936170 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2020-12-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Circulatory collapse, Death, Myocardial infarction
SMQs:, Anaphylactic reaction (narrow), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, arterial (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-31
   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: ; ; BETNOVATE; ; ; ; ; ; ;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Acute myocardial infarction; Basal cell carcinoma; Cataract; Chronic kidney disease; Colitis ischaemic; Debridement (Arthroscopic debridement of patella); Essential hypertension; Mitral valve incompetence; Myocardial ischaemia; Neoplasm malignant (other/unspecified site); Transurethral bladder resection; Comments: Patient has not had symptoms associated with COVID-19. Patient has not been tested/or has had an inconclusive test for COVID-19. Patient is not enrolled in clinical trial.
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021012711

Write-up: Myocardial infarct; Circulatory collapse; This is a spontaneous report from a contactable physician from the regulatory authroity. The regulatory authority report number is GB-MHRA-ADR 24553112 and GB-MHRA-WEBCOVID-20210104143047. An 82-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number: EJ1688), via an unspecified route of administration, on 31Dec2020 at a single dose for COVID-19 vaccination. Medical history included mitral valve incompetence from 08May2020, myocardial ischaemia from 07May2020, acute myocardial infarction from 07May2020, cataract from 29Nov2019, chronic kidney disease from 03Oct2013, colitis ischaemic from 23May2013, basal cell carcinoma from 20Apr2012, transurethral bladder resection on 06Sep2005, neoplasm malignant (other/unspecified site) from 16Aug2005, debridement (arthroscopic debridement of patella) on 12Jan2005, and essential hypertension from 2005. The patient had not had symptoms associated with COVID-19. The patient was not been tested/or had an inconclusive test for COVID-19. The patient was not enrolled in clinical trial. Concomitant medications included allopurinol (MANUFACTURER UNKNOWN), atorvastatin (MANUFACTURER UNKNOWN), betamethasone valerate (BETNOVATE), bisoprolol (MANUFACTURER UNKNOWN), furosemide (MANUFACTURER UNKNOWN), glyceryl trinitrate (MANUFACTURER UNKNOWN), loperamide (MANUFACTURER UNKNOWN), omeprazole (MANUFACTURER UNKNOWN), phenoxymethylpenicillin (MANUFACTURER UNKNOWN), and ramipril (MANUFACTURER UNKNOWN). The patient experienced myocardial infarct and circulatory collapse on 31Dec2020. The event, myocardial infarct, was reported as fatal. It was reported that the patient collapsed at home the evening after vaccination. The clinical outcome of myocardial infarct was fatal and of circulatory collapse was not recovered. The patient died on 31Dec2020. The cause of death was reported as myocardial infarct. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Myocardial infarct


VAERS ID: 937724 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, 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: DEPFIZER INC2021006738

Write-up: Death in connection with the vaccination and/or COVID-19 disease/positivity; Death in connection with the vaccination and/or COVID-19 disease/positivity; This is a spontaneous report from a contactable physician. This physician reported similar events for two patients. This is the first of two reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On an unspecified date, there was death in connection with the vaccination and/or COVID-19 disease/positivity. It was reported that: two deceased were autopsied, whose death was in connection with the vaccination or COVID-19 disease/positivity. The clinical outcome of death in connection with the vaccination and/or COVID-19 disease/positivity was fatal. The patient died on an unspecified date. The cause of death was reported as: death in connection with the vaccination and/or COVID-19 disease/positivity. An autopsy was performed, and the results were not reported.; Sender''s Comments: The association between the event lack of effect (death was in connection with the vaccination or COVID-19 disease positivity) with BNT162b2 can not be fully excluded given the limited information. 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.,Linked Report(s) : DE-PFIZER INC-2021006905 same reporter, same product, same event, different patient; Reported Cause(s) of Death: Death in connection with the vaccination and/or COVID-19 disease/positivity; Death in connection with the vaccination and/or COVID-19 disease/positivity


VAERS ID: 937998 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2020-12-17
Onset:2020-12-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Death, General physical health deterioration, Malaise, Tachycardia, Urinary tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (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: MATRIFEN; ; ; ; ;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic kidney disease; Dementia Alzheimer''s type; Frailty; Recurrent urinary tract infection
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021009353

Write-up: Tachycardia; Unwell; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB GB-MHRA-EYC 00235994, Safety Report Unique Identifier GB-MHRA-ADR 24545770, received from Regulatory Authority. An 85-years-old patient of an unspecified gender received bnt162b2 (BNT162B2) (batch/lot number unknown), intramuscular on 17Dec2020 at single dose for covid-19 immunisation. Medical history included chronic kidney disease, frailty, recurrent urinary tract infection, dementia alzheimer''s type, all from an unknown date and unknown if ongoing. Concomitant medication included fentanyl (MATRIFEN), folic acid (FOLIC ACID), colecalciferol (COLECALCIFEROL), omeprazole (OMEPRAZOLE), citalopram (CITALOPRAM), paracetamol (PARACETAMOL), all taken from unknown date for unspecified indication. The patient experienced unwell and tachycardia on 18Dec2020. The events were medically significant. The event outcome was unknown. Detail clinical course was provided as patient received vaccine on 17Dec2020, the following day she seemed unwell and tachycardic. No evidence of allergy, fever or coronavirus symptoms. Patient deteriorated over the weekend and passed away 3 days later. Cause of death on certificate was probable urinary tract infection. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: urinary tract infection


VAERS ID: 938038 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-04
Onset:2021-01-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiopulmonary failure, Death
SMQs:, Cardiac failure (narrow), Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-04
   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:
Current Illness: Communication disorder NOS; Frailty; Memory impairment; Mobility decreased
Preexisting Conditions: Medical History/Concurrent Conditions: Vascular dementia
Allergies:
Diagnostic Lab Data: Test Date: 202012; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative; Test Date: 202012; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative; Test Date: 20201218; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Negative
CDC Split Type: GBPFIZER INC2021012517

Write-up: Acute cardio-respiratory event and died a few hours later; This is a spontaneous report received from a contactable physician by Pfizer from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-20210107093111. Safety Report Unique Identifier GB-MHRA-ADR 24565959. An 84-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at single dose, on 04Jan2021, for COVID-19 immunisation. Patient was elderly and frail and gradually declining in mobility, communication and memory over the last 12 months. Relevant medical history also included vascular dementia form an unspecified date and unknown if ongoing. Concomitant medications were unknown. Patient was not enrolled in clinical trial. COVID-19 virus test was performed twice on an unspecified date, in Dec2020 and on 18Dec2020 and the results were negative. On 04Jan2021, at 06:00 PM, the patient experienced acute cardio-respiratory event and died a few hours later. It was unknown if autopsy was done. Since the vaccination, the patient has not been tested for COVID-19. Patient did not have symptoms associated with COVID-19. The patient was kept comfortable in the nursing home in these last few hours. There was no way to know whether the vaccine was to blame at all, it was unlikely. No follow-up attempts are possible, information about lot number cannot be obtained.; Reported Cause(s) of Death: Cardio-respiratory failure


VAERS ID: 939332 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2021-01-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-03
   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: Medical History/Concurrent Conditions: Dementia Alzheimer''s type (Vascular and Alzheimer''s mixed dementia); Fluid intake reduced (patient known to not be eating or drinking); General physical health deterioration (Patient known to be declining); Oral intake reduced (patient known to not be eating or drinking); Vascular dementia (advanced dementia)
Allergies:
Diagnostic Lab Data: Test Date: 20201227; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC2021012468

Write-up: Death; Malaise; Vomiting; This is a spontaneous report received from a contactable physician from the Regulatory Agency (RA). The Regulatory Authority report number is GB-MHRA-WEBCOVID-20210105172532, Safety Report Unique Identifier GB-MHRA-ADR 24558660. An 81-year-old female patient received bnt162b2 (BNT162B2) (lot# EJ1688), via an unspecified route of administration, on 30Dec2020, at single dose, for COVID-19 immunisation. Medical history included vascular dementia (advanced dementia), dementia Alzheimer''s type (vascular and Alzheimer''s mixed dementia), oral intake reduced (patient known to not be eating or drinking), fluid intake reduced, (patient known to not be eating or drinking), general physical health deterioration (patient known to be declining); all from an unknown date and unknown if ongoing. Concomitant medications were not reported. The patient experienced death on 03Jan2021, malaise on 01Jan2021 with fatal outcome, vomiting on 01Jan2021 with fatal outcome. It was reported that 48 hours after vaccination the patient became unwell, vomited and then died on 03Jan2021. The patient underwent lab tests and procedures which included COVID-19 virus test: negative on 27Dec2020. Patient has been not tested positive for COVID-19 since having the vaccine. It was not reported if an autopsy was performed. It was not known whether vaccine caused reaction. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Malaise; Vomiting; Death


VAERS ID: 939334 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-30
Onset:2021-01-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Dyspnoea exertional, SARS-CoV-2 test negative
SMQs:, Pulmonary hypertension (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-02
   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: ; ; ; ; ; ; ;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Basal cell carcinoma; Bowen''s disease; Chronic kidney disease; Essential hypertension
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021012521

Write-up: breathless on exertion; This is a spontaneous report received from a contactable other health professional received from the United Kingdom''s Medicines and Healthcare products Regulatory Agency (UK-MHRA). The regulatory authority report number is GB-MHRA-ADR 24561910, other case identifier number: GB-MHRA-WEBCOVID-20210106094618. An 80-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot no: EJ1688), via an unspecified route of administration on 30Dec2020 single dose for covid-19 immunisation. Medical history included Bowen''s disease, basal cell carcinoma, chronic kidney disease and essential hypertension, all unknown if ongoing. Concomitant medication included alfacalcidol (unknown manufacturer), amlodipine (unknown manufacturer), atorvastatin (unknown manufacturer), clopidogrel (unknown manufacturer), prazosin (unknown manufacturer), sodium bicarbonate (unknown manufacturer), folic acid (unknown manufacturer), furosemide (unknown manufacturer). The patient experienced breathless on exertion on 02Jan2021. The patient died on 02Jan2021 due to the event. The patient underwent lab tests and procedures which included sars-cov-2 test: no - negative covid-19 test on unknown date. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Dyspnoea exertional


VAERS ID: 940902 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-01-08
Onset:2021-01-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6796 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-08
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021016328

Write-up: Death 2 hours after vaccination in a retirement home; This is a spontaneous report from a contactable physician. A patient of unspecified age and gender received BNT162B2 (COMIRNATY; PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number EJ6796), via an unspecified route of administration on 08Jan2021 as first single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 08Jan2021, at 19:24, death 2 hours after vaccination in a retirement home was noted. The patient died on 08Jan2021. It was not reported if an autopsy was performed.; Sender''s Comments: The limited information provided in this report does not allow a full assessment of the case. The event "death" is assessed as related to the suspect drug per company guidance. This case will be reassessed when additional information, particularly the clinical course before death, complete medical history and concomitant medication and autopsy report, 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: Death 2 hours after vaccination in a retirement home


VAERS ID: 940935 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-05
Onset:2021-01-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BJ1688 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-07
   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: Comments: Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:no-negative COVID-19 test
CDC Split Type: GBPFIZER INC2021017066

Write-up: Death; Vomiting; This is a spontaneous report from a contactable other health professional from the Regulatory Agency. The regulatory authority report number is GB-MHRA-ADR 24573192. An elderly female patient received the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: BJ1688 and EJ1688; as reported), via an unspecified route of administration on 05Jan2021 at 12:26 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient had not had symptoms associated with COVID-19; and was not enrolled in the clinical trial. On 05Jan2021 at 12:51, the patient experienced vomiting (non-serious); 25 minutes post vaccine (had further vomiting episodes). On 07Jan2021 at 01:00, the patient experienced death; which caused death, and was medically significant. The patient had not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: no-negative COVID-19 test on an unspecified date. The clinical outcome of the event, vomiting, was unknown. The clinical outcome of the event, death, was fatal. The patient died on 07Jan2021 at 01:00 due to unknown cause of death. An autopsy was not performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Death


VAERS ID: 940940 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-03
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4175 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: Medical History/Concurrent Conditions: Cardiac disorder (intended for valve replacement surgery); Diabetes mellitus; Mobility decreased
Allergies:
Diagnostic Lab Data: Test Name: monitor; Result Unstructured Data: Test Result:asystole; Test Name: heart sounds; Result Unstructured Data: Test Result:without heart sounds; Test Name: pupils; Result Unstructured Data: Test Result:pupils do not respond to light
CDC Split Type: ILPFIZER INC2021019507

Write-up: heart pain; cardiac and respiratory arrest; cardiac and respiratory arrest; This is a spontaneous report from a contactable consumer or other non hcp received via regulatory authority. This consumer reported different fatal events for four patients. This is the first of four reports. A 63-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EK4175) via an unspecified route of administration on 03Jan2021 at single dose for covid-19 immunisation. Medical history included Nursing background, cardiac, intended for valve replacement surgery, diabetes mellitus (DM). The patient''s concomitant medications were not reported. The patient was vaccinated on 03Jan2021 with the first dose. From the moment of the vaccine he complained about heart pain. Cardiopulmonary resuscitation (CPR) was performed by the persons on call without an electric shock, emergency services arrived after 5 minutes, resuscitation continued asystole on the monitor, received 4 doses of adrenaline IV, respiration through mask and ambu. After 20 minutes of resuscitation pupils do not respond to light, without heart sounds. The patient died from cardiac and respiratory arrest in Jan2021. It was not reported if an autopsy was performed. The outcome of event heart pain was unknown.; Sender''s Comments: Linked Report(s) : IL-PFIZER INC-2021019632 Same reporter, same product, different patient/events.;IL-PFIZER INC-2021019633 Same reporter, same product, different patient/events.;IL-PFIZER INC-2021019634 Same reporter, same product, different patient/events.; Reported Cause(s) of Death: cardiac and respiratory arrest; cardiac and respiratory arrest


VAERS ID: 940941 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-07
Onset:2021-01-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4238 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Feeling abnormal
SMQs:, Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-08
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer; Diabetes; Hypercholesterolemia; Osteoarthrosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2021019634

Write-up: felt bad; This is a spontaneous report from a contactable consumer. This consumer reported different fatal events for four patients.This is the fourth of four reports. A 71-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number EK4238) via an unspecified route of administration on 07Jan2021 at a single dose for COVID-19 immunisation. Medical history included oncological patient, diabetes, hypercholesterolemia, osteoarthrosis. Concomitant medications were not reported. The patient went out for work a day after he received the vaccine, he felt bad on 08Jan2021 and MDA was called, shortly afterwards his death was determined by MDA. The date of death was on 08Jan2021. The cause of death was felt bad. The outcome of event was fatal. It was unknown if an autopsy was performed.; Sender''s Comments: Linked Report(s) : IL-PFIZER INC-2021019507 Same reporter, same product, different patient/events; Reported Cause(s) of Death: felt bad


VAERS ID: 941173 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-14
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-06
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: CAPFIZER INC2021018220

Write-up: died of COVID-19/developing symptoms 18 days after his inoculation; died of COVID-19/developing symptoms 18 days after his inoculation; This is a spontaneous report received from a contactable consumer A 90-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), on 14Dec2020 at SINGLE DOSE for COVID-19 immunization. The patient died of COVID-19 on Wednesday (06Jan2021) at the Hospital. The patient was given the vaccine on 14Dec2020 and was due to be vaccinated 21 days later. His second dose was delayed because of provincial plan to vaccinate as many people as quickly as possible. The patient started developing symptoms 18 days after his inoculation so the second dose would not have helped him. No other details provided. Information on lot/batch number has been requested.; Reported Cause(s) of Death: died of COVID-19


VAERS ID: 941174 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-24
Onset:2020-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood pressure decreased, Death, Heart rate increased, Restlessness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-29
   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:
Preexisting Conditions: Medical History/Concurrent Conditions: Dementia; Urinary tract infection
Allergies:
Diagnostic Lab Data: Test Date: 20201226; Test Name: blood pressure; Result Unstructured Data: Test Result:decreased; Test Date: 20201226; Test Name: pulse; Result Unstructured Data: Test Result:increased; Test Date: 20201227; Test Name: home doctor examination; Result Unstructured Data: Test Result:stable with persistent sensitivity to pressure of; Comments: stable with persistent sensitivity to pressure of the abdomen
CDC Split Type: CHPFIZER INC2021017201

Write-up: first death case due to Covid-19 vaccination in this country/deterioration in the general condition; stomach was hard and caused pain under pressure; Urethral and abdominal pain; abdominal pain/stomach was hard and caused pain under pressure; restless; his blood pressure dropped; pulse increased; This case was originally submitted under WWID AT-PFIZER INC-2020519756. Upon follow-up, reporter with regulatory authority was considered as primary reporter; as a result of this update case is being resubmitted under new WWID CH-PFIZER INC- 2021017201. As a consequence, this follow-up report will be indicated as an initial report. This is a spontaneous report from six contactable consumers and a contactable other health professional. A 91-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; COMIRNATY), via an unspecified route of administration on 24Dec2020 at single dose for COVID-19 vaccination. Medical history included dementia and urinary tract infection from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The resident had previously reacted negatively to a flu vaccine and therefore no further vaccinations were recommended. The patient experienced urethral and abdominal pain, restless, his blood pressure dropped, pulse increased all on 26Dec2020, deterioration in the general condition and death on 29Dec2020. On Christmas Eve, the residents of a nursing home for dementia were vaccinated with the Pfizer/Biontech vaccine. The affected, otherwise healthy resident, suffered from pain in the urethra and abdomen two days later. The examination by the home doctor revealed a decrease in blood pressure and an increase in the pulse on 26Dec2020. At the last consultation on Sunday evening, 27Dec2020, the patient was stable with persistent sensitivity to pressure of the abdomen. The family doctor in charge examined the patient one last time on Sunday evening, 27Dec2020. He was calm, but his stomach was hard and caused pain under pressure. The following day, the management of the institution did not report back to the home doctor. On the morning of 29Dec2020, the nursing home informed the doctor about a deterioration of the general condition. By the time the doctor was called back the same morning, the patient had already died, vaccinated on Christmas Eve and dead five days later. The patient underwent lab tests and procedures also included home doctor examination: condition was stable with persistent sensitivity to pressure of the abdomen on 27Dec2020. The patient died on 29Dec2020, which was the first death case due to COVID-19 vaccination in this country. It was not reported if an autopsy was performed. The news of the death of a 91-year-old person after he was vaccinated against COVID-19 is circulating on social media channels and information platforms. Investigations by the health authorities have shown that due to the medical history and the course of the disease, a connection between death and the COVID-19 vaccination is unlikely. Neither the medical history nor the acute course of the disease suggest a direct causal connection between the COVID-19 vaccination and death. The comprehensive information available indicates the pre-existing diseases as a natural cause of death. This was also noted on the death certificate. It soon became clear that the home physician, who had implied a connection between vaccination and the death of his elderly patient, was himself. Quoted from the medical record and message spread by email, it was possibly overlooked that patient had symptoms of a urinary tract infection and did not prescribe antibiotics. Event occurred in a country different from that of the reporter. This may be a duplicate report if another reporter from the country where the event occurred has submitted the same information to his/her local agency. Information on the Lot/Batch number has been requested. Follow-up (05Jan2021): New information received from Pfizer Employee, who sent a follow-up from another source included medical history urinary tract infection and cause of death updated. Information on the Lot/Batch number has been requested. Follow-up (08Jan2021): New information received clarified that Reporter with regulatory authority is to be considered as primary reporter. Information on the Lot/Batch number has been requested.; Sender''s Comments: Based on the information available, a possible contributory role of the suspect products cannot be excluded for the reported events due to temporal association. However patient old age of 91 years and other underlying medical conditions could have played a contributory role. Further information including autopsy reports would be helpful for a meaningful medical assessment 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: first death case due to Covid-19 vaccination in this country/deterioration in the general condition


VAERS ID: 944114 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-19
Onset:2020-12-29
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0553 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-29
   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: ; LANSOPRAZOL;
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Ankle swelling (slight ankle swelling awaiting head ct scan and bloods.); Cerebrovascular accident (previous CVA.); Cholesterol; Memory impairment (Recent memory problems.); Oesophagitis; Waldenstrom''s macroglobulinemia; Comments: Patient has not had symptoms associated with COVID-19 Patient has not been tested/or has had an inconclusive test for COVID-19. Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021016664

Write-up: Sudden death; This is a spontaneous report from a contactable physician from the regulatory authority. The regulatory authority report number is GB-MHRA-ADR 24556755. An 86-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number EJ0553), via an unspecified route of administration on 19Dec2020 as single dose for COVID-19 immunization. Medical history included Waldenstrom''s macroglobulinemia for Waldenstrom''s macroglobulinaemia, memory impairment, with recent memory problems, cerebrovascular accident , with previous CVA, joint swelling , reported as slight ankle swelling awaiting head CT scan and bloods, oesophagitis, and cholesterol, all from an unknown date and unknown if ongoing. Concomitant medication included acetylsalicylic acid (MANUFACTURER UNKNOWN) for Waldenstrom''s macroglobulinaemia, lansoprazol (MANUFACTURER UNKNOWN) for oesophagitis, simvastatin (MANUFACTURER UNKNOWN) for blood cholesterol. The patient had sudden death on 29Dec2020. The patient died on 29Dec2020. It was not reported if an autopsy was performed. The reporter did not think the COVID vaccination caused the patients death; It did not appear to be related. The patient was seen by the physician on the 24th (not otherwise specified), and was fine. The patients son also saw the patient on the 28th (not otherwise specified) and also fine with no side effects from the jab. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information currently provided, the company considers the patient death is unrelated to the vaccine use; the advance old patient having multiple pre-existing medical conditions including Waldenstrom''s macroglobulinaemia and cerebrovascular accident, which more likely led the patient to sudden death.; Reported Cause(s) of Death: Sudden death unexplained


VAERS ID: 944118 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2020-12-27
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       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: 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: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Yes - Positive COVID-19 test
CDC Split Type: GBPFIZER INC2021016254

Write-up: SARS-CoV-2 infection; SARS-CoV-2 infection; This is a spontaneous report from a contactable physician received by Regulatory Agency . The regulatory authority report number is GB-MHRA-ADR 24558365 & GB-MHRA-WEBCOVID-20210105143744. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, on an unspecified date at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Patient was not enrolled in clinical trial. The patient experienced SARS-coV-2 infection on 27Dec2020. The patient underwent lab tests and procedures which included COVID-19 virus test: yes - positive covid-19 test on an unspecified date. The clinical outcome of SARS-coV-2 infection was fatal. The patient died on an unspecified date. An autopsy was not performed. No follow-up attempts are possible; information about batch/lot number cannot be obtained.; Reported Cause(s) of Death: SARS-CoV-2 infection


VAERS ID: 944121 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-23
Onset:2020-12-31
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Death, SARS-CoV-2 test negative
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), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-31
   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: Dementia
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiac pacemaker insertion; Comments: Patient has not had symptoms associated with COVID-19 Unsure if patient is enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021016800

Write-up: Cardiac arrest; This is a spontaneous report from a contactable physician. This is a report received from the MHRA. Regulatory authority report number GB-MHRA-WEBCOVID-20210105171610, Safety Report Unique Identifier GB-MHRA-ADR 24558665. A male patient of an unspecified age received BNT162B2 (Pfizer-Biontech Covid-19 Vaccine), via an unspecified route of administration on 23Dec2020, at single dose for covid-19 vaccination. Medical history included ongoing dementia, and cardiac pacemaker insertion on an unknown date. Patient has not had symptoms associated with COVID-19. Unsure if patient was enrolled in clinical trial. The patient''s concomitant medications were not reported. The patient experienced cardiac arrest on 31Dec2020. Had spontaneous cardiac arrest 9 days (to be clarified) after vaccination doubtful implicated but new vaccine of course. Patient had not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: no - negative covid-19 test on an unspecified date. The patient died of cardiac arrest on 31Dec2020. It was not reported if an autopsy was performed. Information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Cardiac arrest


VAERS ID: 944154 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-04
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4238 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: Medical History/Concurrent Conditions: Asthma; Dementia; Depression; Gastrointestinal disorder; Heart failure; Living in nursing home
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: heart sounds; Result Unstructured Data: Test Result:asystole without heart sounds
CDC Split Type: ILPFIZER INC2021019632

Write-up: This is a spontaneous report from a contactable consumer. This consumer reported different fatal events for four patients. This is the second of four reports. An 82-year-old female patient in a nursing home received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE lot number: EK4238) via an unspecified route of administration on 04-Jan-2021 at a single dose for COVID-19 immunisation. Medical history included background of asthma, dementia, depression, gastrointestinal and heart failure. Concomitant medications were not reported. 4 Hours after the receipt of the vaccine, she was found in her room on the floor with a bruise on her forehead apparently from a fall, CPR was performed by nursing home staff. Staff performed CPR, asystole without heart sounds, CPR continued for 23 minutes without any change and death was declared. The events occurred in Jan 2021. The date of death was in Jan 2021. The outcome of events was fatal. It was unknown if an autopsy was performed. Sender''s Comments: Linked Report(s): IL-PFIZER INC-2021019507 Same reporter, same product, different patient/events; Reported Cause(s) of Death: was found in her room on the floor with a bruise on her forehead apparently from a fall; was found in her room on the floor with a bruise on her forehead apparently from a fall.


VAERS ID: 944155 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-21
Onset:2020-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Death, Dyspnoea, Haemolytic anaemia, Hypotension, Jaundice, Lymphocytosis, Resuscitation, Tremor
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Haemolytic disorders (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal (treated with nifedipine and TRITACE COMP); Drug hypersensitivity; Hyperlipidemia (treated with statins); Keratitis; Prostate cancer; Prostatectomy
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:low; Test Date: 20201228; Test Name: blood tests; Result Unstructured Data: Test Result:unknown results
CDC Split Type: ILPFIZER INC2021019633

Write-up: hemolytic anemia; reduced air entrance; passed away; low blood pressure; jaundice appeared on the whole body with lymphocytosis; jaundice appeared on the whole body with lymphocytosis; shortness of breath in mild efforts; weakness which expressed by shortness of breath in mild efforts; hands tremor; shortness of breath; This is a spontaneous report from a contactable consumer received via regulatory authority. This consumer reported different fatal events for four patients. This is the third of four reports. A 72-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number was not specified) via an unspecified route of administration on 21Dec2020 at a single dose for COVID-19 immunisation. Medical history included Kerattis, prostatectomy other, blood pressure problems (treated with nifedipine and hydrochlorothiazide/ramipril (TRITACE COMP)), hyperlipidemia (treated with statins), oncological patient-underwent radical restriction of the prostate, and sensitivity to phenylephrin. Concomitant medications were not reported. Three days after the vaccine (on 24Dec2020) he started to feel shortness of breath, arrived for hospitalization 10 days after vaccination. Five days after vaccination (on 26Dec2020) he experienced weakness which expressed by shortness of breath in mild efforts, hands tremor. 6 days after vaccination (on 27Dec2020) jaundice appeared on the whole body with lymphocytosis. On the day after, he referred to the physician and blood tests were sent. He was hospitalized following diagnosis of hemolytic anemia. He received two blood doses and steroids. Two hours before he passed away, low blood pressure was measured and reduced air entrance, CPR was performed without success and the patient passed away. The date of death was unknown. The cause of death was unknown. It was unknow if an autopsy was performed. The outcome of event unknown cause of death was fatal, and of other events was unknown. Information on the lot/batch number has been requested.; Sender''s Comments: Linked Report(s) : IL-PFIZER INC-2021019507 Same reporter, same product, different patient/events; Reported Cause(s) of Death: passed away


VAERS ID: 945725 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-08
Onset:2021-01-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac failure, Death, Hypotension, Malaise, Mobility decreased, Oxygen saturation decreased, SARS-CoV-2 test negative, Speech disorder
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant 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), Cardiomyopathy (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-11
   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: Comments: The resident had got heart failure. The out of hours GP visited 10/01/2021 and advised she maybe poorly due to having the Covid-19 vaccine. The resident passed away at 7.20am this morning 11/01/2021 Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Date: 20210110; Test Name: blood pressure; Result Unstructured Data: Test Result:low; Test Date: 20210110; Test Name: sats; Result Unstructured Data: Test Result:low; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:no-negative COVID-19 test
CDC Split Type: GBPFIZER INC2021020138

Write-up: heart failure; Death; feeling sick; changes with speech and mobility; changes with speech and mobility; This is a spontaneous report from a contactable consumer received from the regulatory authority. The regulatory authority report number is GB-MHRA-WEBCOVID-20210111094207, Safety Report Unique Identifier: GB-MHRA-ADR 24577774. A 97-year-old female patient received the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: EJ1688), via an unspecified route of administration on 08Jan2021 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 10Jan2021, the patient experienced feeling sick (medically significant), changes with speech and mobility (speech disorder) (medically significant). On 11Jan2021, the patient experienced death (death, medically significant). On an unspecified date, the patient experienced heart failure (death, medically significant). The clinical course was reported as follows: "The resident had got heart failure." The patient was feeling sick on 10Jan2021 and was concerned as there were changes with speech and mobility. Emergency was called, and the ambulance arrived. It was stated the sats were low and blood pressure was low. The ambulance crew called for an out of hours general practitioner (GP) to come and see the patient. The out of hours general practitioner (GP) visited on 10Jan2021 and advised "she maybe poorly due to having the Covid-19 vaccine" that was administered on the 08Jan2021. The resident passed away at 07:20 on morning 11Jan2021. The patient had not tested positive for COVID-19 since having the vaccine. The patient had not had symptoms associated with COVID-19. The patient was not enrolled in a clinical trial. The patient underwent lab tests and procedures which included COVID-19 virus test: no-negative COVID-19 test on an unspecified date, oxygen saturation (sats): low on 10Jan2021, blood pressure: low on 10Jan2021. The clinical outcome of the event, death and heart failure, was fatal. The clinical outcome of the event, feeling sick and changes with speech and mobility, was unknown. The patient died on 11Jan2021 due to heart failure. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: heart failure


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