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From the 10/15/2021 release of VAERS data:

Found 17,128 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

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VAERS ID: 1700103 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-05
Onset:2021-09-05
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Case fully vaccinated with COVID 19 vaccine. Dose #2 given on 2/5/2021. Tested positive for COVID 19 on 9/5/2021. Was admitted to Medical Center on 9/6/2021 and expired while still hospitalized on 9/14/2021.


VAERS ID: 1700162 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-19
Onset:2021-08-31
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death, Dyspnoea, Endotracheal intubation, Mental status changes
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 5
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: Patient has an underlying history of hypothyroidism, oropharyngeal cancer post chemotherapy who presented to the ER on 08/22/2021 with altered mental status and shortness of breath
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per medical records, patient has an underlying history of hypothyroidism, oropharyngeal cancer post chemotherapy who presented to the ER on 08/22/2021 with altered mental status and shortness of breath. Pt is also a former smoker. Pt was intubated in the ED on 08/22. Pt expired on 09/05/2021.


VAERS ID: 1700191 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-12
Onset:2021-09-08
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 RA / IM

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

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Minimal nursing notes were provided. Patient lived at Healthcare facility and died at their sister facility - Nursing and Rehabilitation.


VAERS ID: 1700218 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-20
Onset:2021-02-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Hypoxia, Laboratory test, Pyrexia, SARS-CoV-2 test
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-16
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, anxiety, osteoarthritis, seizure.
Allergies: Chlorpromazine, divalproex sodium, paliperidone
Diagnostic Lab Data: Labwork, covid test, cxr.
CDC Split Type:

Write-up: Pt came to ER c/o fever, hypoxia.


VAERS ID: 1700221 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-01
Onset:2021-07-29
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cellulitis, Chills, Cough, Death, Dyspnoea, Dyspnoea exertional, Hyperhidrosis, Respiratory symptom, SARS-CoV-2 test positive, Septic shock, Urinary tract infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Toxic-septic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-14
   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:
Current Illness:
Preexisting Conditions: Medical history of CAD, CVA, Diabetes Mellitus, and hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with symptoms of of URI, shortness of breath, dyspnea on exertion, diaphoresis, chills, and worsening cough. On arrival to ED, O2 sat noted to be 88%, rapid COVID test was positive, and patient was admitted for COVID-19 infection. Patient became fully vaccinated on 03/01/2021 (Moderna). On 08/14/2021, patient passed away due to COVID 19, Cellulitis, Septic Shock, and UTI


VAERS ID: 1700248 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-25
Onset:2021-09-14
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / SYR

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: 2021-09-14
   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: COVID RELATED DEATH; FULLY VACCINATED PT.


VAERS ID: 1700284 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-13
Onset:2021-01-26
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, Dyspnoea, Laboratory test, 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: 2021-02-02
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Arthritis, COPD, DVT, GER, Hypercholesterolemia, HTN, hypothyroid, osteoarthritis, PAD, sleep apnea.
Allergies: NKA
Diagnostic Lab Data: Covid test, lab work, CXR.
CDC Split Type:

Write-up: Pt came to ER c/o difficulty breathing and cough. Onset 2 days prior.


VAERS ID: 1700296 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-22
Onset:2021-09-14
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / SYR

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: 2021-09-14
   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: COVID RELATED DEATH; FULLY VACCINATED PT.


VAERS ID: 1700305 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-25
Onset:2021-07-27
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Death, Dyspnoea, Hypoxia
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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-20
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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: acute on chronic respiratory failure secondary to COVID, hypoxic, SOB, weakness, in hospital from 08/01/2021 to 08/12/2012 then discharged to long term care facility where he passed away


VAERS ID: 1700310 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-08-22
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Death, Dyspnoea, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pulmonary fibrosis, diabetes, hypertension, hypothyroidism, hyperlipidemia and dementia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital on 08/22/2021 with nausea, vomiting, and shortness of breath. Died on 08/23/2021


VAERS ID: 1700329 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-23
Onset:2021-08-30
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNAVAILABLE / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Activated partial thromboplastin time prolonged, Acute kidney injury, Acute myocardial infarction, Acute respiratory failure, Alanine aminotransferase increased, Anisocytosis, Aspartate aminotransferase normal, Base excess abnormal, Basophil count, Basophil percentage decreased, Blood albumin decreased, Blood bicarbonate decreased, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood fibrinogen decreased, Blood glucose increased, Blood magnesium normal, Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Bronchoscopy abnormal, Calcium ionised decreased, Carbon dioxide abnormal, Carbon dioxide decreased, Cardiac arrest, Catheterisation cardiac abnormal, Chest X-ray abnormal, Coronary artery occlusion, Culture, Death, Dyspnoea, Electrocardiogram abnormal, Endotracheal intubation, Eosinophil count decreased, Eosinophil percentage decreased, Fatigue, Fibrin D dimer, Full blood count, Haematocrit decreased, Haemofiltration, Haemoglobin decreased, Haemorrhage, Hypoxia, Immature granulocyte count increased, Intensive care, International normalised ratio increased, Lung assist device therapy, Lung opacity, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume increased, Mean platelet volume increased, Mechanical ventilation, Metabolic function test, Monocyte count, Monocyte percentage decreased, Myocardial infarction, Neutrophil count increased, Oxygen saturation decreased, PCO2 decreased, PO2 decreased, Platelet count decreased, Prothrombin time prolonged, Pulmonary alveolar haemorrhage, Pulmonary haemorrhage, Pyrexia, Red blood cell count decreased, Red blood cell nucleated morphology present, Red cell distribution width increased, Right ventricular failure, SARS-CoV-2 test negative, Sepsis, Septic shock, Sinus tachycardia, Tachycardia, Urine analysis normal, Vomiting, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (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 (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ergocalciferol, vitamin D2, 50,000 Units capsule pimecrolimus cream (ELIDEL) 1 % cream triamcinolone ointment (KENALOG) 0.1 % ointment
Current Illness: Lupus
Preexisting Conditions: Lupus diagnosis on 7/21/21
Allergies: Bactrim
Diagnostic Lab Data: Results for patient 9/1/2021 04:10 Arterial pH: 7.35 Arterial pCO2: 31.5 (L) Arterial pO2: 71.6 Arterial HCO3: 16.8 (L) Arterial Total CO2: 17.8 (L) Arterial Base Excess/Deficit: -7.6 Arterial Measured O2 Saturation: 90.0 Sodium Blood: 136 Potassium Blood: 4.4 Chloride Blood: 114 (H) Carbon Dioxide: 17.8 (L) Glucose Blood: 241 (H) BUN: 27 (H) Creatinine Blood: 0.82 Calcium Blood: 6.8 (L) WBC: 11.3 (H) RBC: 2.33 (L) Hemoglobin: 7.2 (L) Hematocrit: 22.8 (L) MCV: 97.9 MCH: 30.9 MCHC: 31.6 (L) Platelet Count: 184 MPV: 11.4 (H) RDW: 17.9 (H) Nucleated RBC Automated: 0.2 (H) Differential Type: MANUAL DIFF % Seg: 97.5 (H) % Lymphocytes: 1.0 (L) % Monocytes: 1.0 % Meta: 0.5 (H) Absolute Neutrophils: 11.018 (H) Abs Seg: 11.02 (H) Absolute Lymphocytes: 0.11 (L) Absolute Monocytes: 0.11 Abs Meta: 0.06 (H) Total Cells Counted: 198 Anisocytosis: SLIGHT Results for patient 9/1/2021 13:38 Arterial pH: 7.11 (LL) Arterial pCO2: 62.6 (HH) Arterial pO2: 70.3 Arterial HCO3: 18.8 (L) Arterial Total CO2: 20.7 Arterial Base Excess/Deficit: -12.7 Arterial Measured O2 Saturation: 85.2 (L) Sodium Blood: 137 Potassium Blood: 4.7 Chloride Blood: 119 (H) Carbon Dioxide: 20.7 (L) Glucose Blood: 226 (H) BUN: 31 (H) Creatinine Blood: 0.89 Calcium Blood: 6.6 (L) WBC: 17.0 (H) RBC: 2.90 (L) Hemoglobin: 8.9 (L) Hematocrit: 28.7 (L) MCV: 99.0 MCH: 30.7 MCHC: 31.0 (L) Platelet Count: 187 MPV: 11.0 (H) RDW: 16.9 (H) Nucleated RBC Automated: 0.1 (H) Differential Type: AUTOMATED DIFF % Neutrophils: 94.1 (H) % Imm Gran: 1.2 (H) % Lymphocytes: 1.1 (L) % Monocytes: 3.2 % Eosinophils: 0.0 % Basophils: 0.4 Absolute Neutrophils: 15.930 (H) Abs Imm Gran: 0.21 (H) Absolute Lymphocytes: 0.19 (L) Absolute Monocytes: 0.55 (H) Absolute Eosinophils: 0.00 Absolute Basophils: 0.07 Results for patient 9/4/2021 16:04 Arterial pH: 7.40 Arterial pCO2: 47.4 (H) Arterial pO2: 60.2 (L) Arterial HCO3: 28.5 (H) Arterial Total CO2: 29.9 (H) Arterial Base Excess/Deficit: 3.7 Arterial Measured O2 Saturation: 89.7 (L) Sodium Blood: 146 (H) Potassium Blood: 3.0 (L) Chloride Blood: 106 Carbon Dioxide: 29.9 Glucose Blood: 176 (H) BUN: 67 (HH) Creatinine Blood: 2.53 (H) Calcium Blood: 8.3 (L) Ionized Calcium: 4.66 Magnesium Blood: 1.9 WBC: 8.7 RBC: 2.47 (L) Hemoglobin: 7.2 (L) Hematocrit: 21.9 (L) MCV: 88.7 MCH: 29.1 MCHC: 32.9 Platelet Count: 96 (L) MPV: 11.2 (H) RDW: 16.1 (H) Nucleated RBC Automated: 0.6 (H) Differential Type: AUTOMATED DIFF % Neutrophils: 93.0 (H) % Imm Gran: 1.6 (H) % Lymphocytes: 1.5 (L) % Monocytes: 3.7 % Eosinophils: 0.0 % Basophils: 0.2 Absolute Neutrophils: 8.120 (H) Abs Imm Gran: 0.14 (H) Absolute Lymphocytes: 0.13 (L) Absolute Monocytes: 0.32 Absolute Eosinophils: 0.00 Absolute Basophils: 0.02 PT Result: 16.1 (H) INR Result: 1.25 PTT Result: 94.3 (H) TT Result: $g100.0 (H) D Dimer: 2.56 (H) Fibrinogen: 192 (L) Heparin Level.: 0.36 PREOPERATIVE DIAGNOSIS: STEMI POSTOPERATIVE DIAGNOSIS: stemi Procedure(s): Left heart catheterization with coronary angiography JL3 and SCR ANESTHESIA: General ESTIMATED BLOOD LOSS: Minimal COMPLICATIONS: None CONDITION: Critical ACCESS: 5 Fr left FA FINDINGS: Totally occluded left anterior descending & circumflex coronary arteries. Right coronary artery patent
CDC Split Type:

Write-up: Patient is a 18 y.o. male patient with a past medical history significant for lupus who presents with Pulmonary hemorrhage. About 2 days ago, pt developed fevers and worsening shortness of breath. T max 102 F at home. He did not note anything that relieved or exacerbated his difficulty breathing. He also reported fatigue, abdominal pain and several episodes of NBNB emesis the week prior to admission. No recently chest pain, diarrhea, hematuria, dysuria, headache or neck stiffness. Pt presented to ED yesterday and was treated with antibiotics and discharged, he came back today due to worsening shortness of breath. Of note, pt was had 2 hospital admissions in the last 2 months, most recently for febrile neutropenia. Completed 2 doses of COVID vaccine. At ED, pt arrived with temp of 39.1, HR 143, RR 28, BP 117/67, SpO2 98% EKG with sinus tachycardia, no ST elevations/depressions or other acute ischemic changes. CXR revealed diffuse bilateral airspace opacities without pneumothorax. CBC 10.6$g8.1/27.4<203, CMP 137/3.9/110/22/18/0.58<99, Ca 7, Alb 1.5, AST 15, ALT 86. UA negative for infection, no protein. CXR with progressive diffuse bilateral airspace opacity with air bronchograms, no pneumothorax. Cultures obtained. Pt was treated with vancomycin, cefepime and levofloxacin for sepsis and concern for pneumonia and given IV fluids per ED sepsis protocol. He was also given Solumedrol 1g. Less likely COVID given vaccination status and negative COVID swab. Due to worsening tachycardia and hypoxia on oxygen, pt was intubated and bleeding in airway was noted. Pt was admitted to the ICU, and pulm crit care performed a bronchoscopy that revealed diffuse alveolar hemorrhage. Repeat CXR in ICU revealed almost complete white out of both lungs. Pt was bagged for almost an hour due to persistent hypoxia. Pt was subsequently transferred to CW due to concern for requiring VV ECMO. On arrival to CW CICU, pt satting low 70s, vent settings titrated and sats improved to 90s. He was continued on Epi, Norepi, Dexmed and Fentanyl. Rheum history: Lupus diagnosed on renal biopsy 7/21/21, on bactrim prophylaxis recently, recent treatment with rituximab, on daily prednisone 30 mg BID Parents spanish speaking. Patient is a 18 y.o. male patient with a past medical history significant for lupus who presents with acute hypoxic respiratory failure requiring mechanical ventilation, septic shock and pulmonary hemorrhage. It is unclear at this time if his pulmonary hemorrhage is related to lupus vs idiopathic process. COVID negative and fully vaccinated, making COVID pneumonia less likely. He is maintaining his MAPs on epinephrine and arterial sats in the 90s on SIMV PC PS. He is candidate for VV ECMO but does not require it at this time due to decreasing vent settings. Rheumatology consulted and large lab workup is underway. Plan to continue broad spectrum antibiotics, close monitoring of hemodynamics and to continue to watch for signs of recurrent pulmonary hemorrhage. Pt requires CICU due to risk of acute cardiopulmonary decompensation. Patient was an 18 yo man with Dx of lupus who presented to hospital (transferred from outside hospital) in respiratory failure due to pulmonary hemorrhage. Due to worsening hypoxemia in spite of mechanical ventilation he was started on VV ECMO. While on VV ECMO, he had a cardiac arrest due to right ventricular failure and was converted to VA ECMO. He also developed acute renal failure and was on CRRT. On 9/14, while on VA ECMO, he developed a massive MI due to occlusion of his LAD and circumflex coronaries. This heart injury was assessed as non recoverable and all further care was considered futile. After given time to the family to say their goodbyes, patient was removed from VA ECMO support and pronounced dead with his family at the bedside on 9/15/2021 at 7:30 am


VAERS ID: 1700395 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-18
Onset:2021-08-25
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 UN / SYR

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: 2021-08-29
   Days after onset: 4
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: Hospitalization and death due to COVID-19


VAERS ID: 1700415 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-08
Onset:2021-04-01
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cerebrovascular accident, Computerised tomogram, Creutzfeldt-Jakob disease, Death, Diplopia, Dizziness, Electroencephalogram, Endotracheal intubation, Gait disturbance, Gait inability, Insomnia, Intensive care, Lumbar puncture abnormal, Magnetic resonance imaging, Memory impairment, Restless legs syndrome, Seizure, Speech disorder
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-17
   Days after onset: 107
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NUMEROUS BLOOD WORK, CAT SCANS, MRI , EEG , LUMBER PUNCTURES
CDC Split Type:

Write-up: DEVELOPED RESTLESS LEG SYNDROME, INSOMNIA, DOUBLE VISION, DIZZINESS WITHIN 3 WEEKS OF LAST SHOT. DIAGNOSED WITH A STROKE ON 05/24/21. WITHIN 24 HOURS OF DISCHARGE, SHE COULD NOT WALK PROPERLY AND HAD TO USE A CANE. RE ENTERED THE HOSPITAL ON 06/7/21 TO REHAB CONTINUED TO DECLINE WITH ADVANCED SYMPTOMS OF GAIT DIFFICULTY, MEMORY AND SPEECH PROBLEMS AND STILL INSOMNIA, ULTIMATELY BEGAN TO HAVE SEIZURES AND WAS INTUBATED AND SEDATED ON 06/21/21. TRANSFERRED TO HOSPITAL 9TH FLOOR NEUROLOGICAL ICU ON 06/25/21 AND BEGAN PROCESS OF DIAGNOSIS WITH A LUMBAR PUNCTURE. RECEIVED THE CJD DIAGNOSIS ON 07/14/21 AND SHE PASSED AWAY ON 07/17/21. MY MOTHER WAS COMPLETELY HEALTHY, WENT TO THE DOCTOR EVERY 6 MONTHS WITH GREAT CHECK UPS , WORKED OUT EVERY DAY, AND LOVED LIFE.


VAERS ID: 1700421 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-08-10
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Death
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular Disease, Hypertension, Atrial fibrillation, hyperlipidemia, thoracic aortic aneurysm
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 08/10/2021 with reports of confusion and weakness. Patient was fully vaccinated. He died on 8/18/2021.


VAERS ID: 1700460 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-04
Onset:2021-08-23
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Cough, Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-07
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Chronic Renal Disease (CKD 3B), Hypertension, Disability, Depression, Anxiety, Alzheimer''s dementia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was brought to ED due to shortness of breath, cough, and worsening confusion. He was hospitalized and died. Patient was fully vaccinated.


VAERS ID: 1700479 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-25
Onset:2021-08-17
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21-2A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / 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: 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: unknown
Current Illness:
Preexisting Conditions: myesthenia graves
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: no adverse advent with vaccine developed covid and passed away


VAERS ID: 1700518 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-18
Onset:2021-08-08
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, Chest X-ray abnormal, Cyanosis, Oxygen saturation decreased, Pneumonia, Pneumonia viral, Positive airway pressure therapy, Pulmonary embolism, Respiratory symptom, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (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: 2021-08-22
   Days after onset: 14
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: ASA, Zithromax, Crestor, Diovan, Losartan, Medrol Dosepak, Met, Zetia
Current Illness: Unknown
Preexisting Conditions: HTN, Hypercholesteremia
Allergies: No known allergies
Diagnostic Lab Data: SARS COV2 COVID 19 PCR (Positive) 08/08/2021
CDC Split Type:

Write-up: Patient here with acute hypoxic respiratory failure, improved with respiratory support via BiPAP. He is hemodynamically stable, awake and alert. He patient has voiced clearly to myself and to multiple nursing staff, Members at the bedside that patient would not wish to be intubated and placed on mechanical ventilation should his respiratory status further deteriorate. Patient had very little oxygen reserve with desaturations very quickly into the high 70s on room air when transitioned from stretcher into bed. He has no prior history of cardiac or pulmonary disease. Presentation highly suspicious for COVID-19, which was confirmed with diagnostic testing here today. Bilateral pneumonia noted on chest XR. Likely viral in nature. Patient presented to the emergency room at this facility by ambulance which had been summoned to his house by his sister whom happens to be a nurse practitioner. Apparently the patient had developed upper respiratory symptoms for the last 5 days or so and at his sister had called in the prescription for Zithromax and a Medrol Pak about 3 days ago. Apparently she went to check on him today and found him cyanotic. When EMS arrived to assess the patient they found his oxygen saturations to be 55% on room air. The patient was placed on a non-rebreather and improved to mid 80s and he was then placed on CPAP with improvement to the low 90s. Upon arrival to the emergency room he was placed on a BiPAP and he has remained stable in terms of oxygenation. Patient reports receiving 2 doses of Pfizer vaccine. He reported not being aware of sick contacts. I had received a call from reading radiologist the reported and small burden of blood clot in the right upper lobe of the lung besides findings compatible with pneumonia. Patient had also been found to be in atrial fibrillation with moderate ventricular response.


VAERS ID: 1700531 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-03-09
Onset:2021-03-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Anticoagulant therapy, Atrial flutter, Cardiogenic shock, Death, Dyspnoea, International normalised ratio increased, Troponin increased
SMQs:, Cardiac failure (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-25
   Days after onset: 136
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: Aspirin 81 mg Atorvastatin 10 mg nightly Carvedilol 3.125 mg twice daily Entresto twice daily Plavix 75 mg daily Spirolactone 25 mg daily Torsemide 40 mg daily
Current Illness:
Preexisting Conditions: Systolic CHF Ischemic Cardiomyopathy CKD stage III Hypertension Type II diabetes with Neuropathy RA
Allergies:
Diagnostic Lab Data: I don''t have test results from March 2021 admission, patient was on heparin 48 hr DVT protocol. Admitted again on 07/18/2021 NSTEMI left ventricle, Died 07/25/2021 - cardiogenic shock. INR on 7/18/2021 1.17 Troponin 7/18/21 1.16, 1.21, 1.14
CDC Split Type:

Write-up: SOB, Sudden onset Atrial Flutter March 10 2021


VAERS ID: 1700543 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2020-12-29
Onset:2021-09-10
   Days after vaccination:255
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: HLD, A FIb, CAD, COPD, CHF, Diabetic, Multiple Comorbidities
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient Death


VAERS ID: 1700557 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-31
Onset:2021-08-07
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pneumonia, Acute respiratory failure with hypoxia and hypercapnia, AKI, Septic Shock
Preexisting Conditions: COPD, Anemia, Acute metabolic encephalopathy, Diastolic function with heart failure, Depression, Emphysema, GAD, Hyperglycemia, Hyperlipidemia, Hyperphpsphatemia, Hyperkalemia, IgG1 Deficiency, Insomnia, Opiod Dependence, Pleural effusion, right.
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient Died


VAERS ID: 1700679 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-07-31
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Death, Endotracheal intubation, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Angioedema (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: 2021-08-31
   Days after onset: 31
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: Protonix, Lantus, dicyclomine, quetiapine
Current Illness: Unknown
Preexisting Conditions: diabetes, stomach ulcer, kidney stone
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient admitted 7/31/21 for covid 19 pneumonia/acute respiratory failure. Resulted positive for COVID 7/29/21. Patient received covid vaccine in March. Patient was exposed to his brother who was positive for COVID 19. Patient was intubated on 8/19 and expired 8/31/21.


VAERS ID: 1700698 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-16
Onset:2021-01-28
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Cough, Dyspnoea, 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: 2021-02-07
   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: COPD, HTN, thyroid disease.
Allergies: NKA
Diagnostic Lab Data: Covid test, CXR.
CDC Split Type:

Write-up: Pt came to ER c/o difficulty breathing and cough.


VAERS ID: 1700712 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-14
Onset:2021-09-08
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Endotracheal intubation, Injury, Multiple fractures, Road traffic accident, SARS-CoV-2 test positive, Skull fractured base, Subarachnoid haemorrhage
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Osteoporosis/osteopenia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to hospital in full trauma alert after motorcycle crash on 9/8. Intubated with subarachnoid hemorrhage with base skull fracture and multiple other fractures. Covid test +. No improvement with multiple trauma appropriate treatments. Family agreed with comfort care on 9/13.


VAERS ID: 1700738 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-06
Onset:2021-01-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-15
   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: N/a
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death


VAERS ID: 1700765 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-06
Onset:2021-08-26
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0431A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Interstitial lung disease
SMQs:, Interstitial lung disease (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: 2021-08-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt diagnosed with COVID-19 on 7/24/2021, succumbed to POST COVID INTERSTITIAL LUNG DISEASE


VAERS ID: 1700768 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-04
Onset:2021-08-26
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Death, Dyspnoea, General physical health deterioration, Hypoxia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted on 08/26 diagnosed with COVID on 08/23. Presented to the hospital with sob, syncope and weakness. DX with COVID PNA, hypoxia, syncope and Afib RVR. also with a PMHx of MS and on fingolimod. Patient continued to decompensate and expired on 09/10/12


VAERS ID: 1700774 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Anion gap increased, Ascites, Blood bicarbonate decreased, Blood chloride decreased, Blood creatinine increased, Blood glucose normal, Blood lactic acid increased, Blood pH decreased, Blood potassium normal, Blood sodium decreased, Blood urea increased, COVID-19, Cardiac arrest, Cardiac failure, Cardiogenic shock, Cardiomegaly, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Congestive hepatopathy, Death, Electrocardiogram ST segment elevation, Fibrin D dimer increased, Glomerular filtration rate decreased, Hepatic failure, Hepatomegaly, Hyperventilation, Inflammation, Metabolic acidosis, Myocarditis, PCO2 decreased, Pericardial effusion, Pneumonia, Renal disorder, Renal failure, SARS-CoV-2 test positive, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (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 (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Active COVID-19 infection suspected based on symptom onset 9/10/2021. Tested positive yesterday, 9/14 and confirmed today in our ED, 9/15.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: EKG showing diffuse ST elevations concerning for myocarditis. Cardiologist did not feel that transfer to a higher level care center immediately for cardiac catheterization indicated. Troponin 113.793. Lactate 14.0. Creatinine 2.97. pH 7.124. Bicarb 9. Anion gap 30. Glucose 144. Sodium 135 potassium 4 chloride 96. BUN 22. SARS-CoV-2 detected. Per radiology: CTA chest: Small to moderate relatively hyperdense pericardial effusion, nonspecific. Mild cardiomegaly. Evidence of heart failure. These findings collectively would be compatible with inflammatory disease. Consider myocarditis or pericarditis. No evidence of pulmonary thromboembolism. Bilateral pneumonia. CTA abdomen and pelvis: No evidence of bowel ischemia. The enlargement of the liver and of mild ascites suggest hepatic congestion. This could reflect either heart failure or liver failure. Heterogeneous appearance of the kidneys, suggesting possible pyelonephritis, but this appearance could also be the result of some other inflammatory process.
CDC Split Type:

Write-up: Death. Presented to the emergency department with diffuse ST elevations concerning for myocarditis. His troponin was elevated at 113. His lactate was 14. He was in renal failure with a creatinine of 2.97, GFR 26. D-dimer was elevated at 1.25 without any obvious pulmonary embolism according to the CT. Upon presentation he was hyperventilating, not complaining of chest pain. Labs demonstrate a significant metabolic acidosis with a pH of 7.124, PCO2 of 15.4. O2 sat 96.8% on room air. Patient unfortunately went into cardiac arrest and was unable to be revived. Cause of death suspected to be myocarditis and cardiogenic shock In the setting of active COVID-19 infection.


VAERS ID: 1700799 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-09-06
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac arrest, Cardioversion, Cough, Death, Endotracheal intubation, Exposure to SARS-CoV-2, Feeling abnormal, Haemoptysis, Resuscitation, SARS-CoV-2 test positive, Sleep disorder, Therapeutic hypothermia, Unresponsive to stimuli, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol MDI PRN, Amiodarone 200 mg BID, Apixaban 5 mg BID, Aspirin 81 mg QD, Atorvastatin 40 mg QD, Benzonatate 100-200 mg TID PRN, Furosemide 40 mg QD, Losartan 100 mg QD, Metoprolol 100 mg BID, Multiple vitamin QD, Pantoprazole 20 mg QD
Current Illness:
Preexisting Conditions: CAD (angiogram August 2013 shows three vessel disease with preserved systolic function), Hyperlipidemia, Hypertension, Class 2 Obseity, Chronic Kidney Disease stage 3, Chronic combined systolic and diastolic congestive heart failure
Allergies: NKDA
Diagnostic Lab Data: Covid-19 positive from sample collected 9/6/2021 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 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis. Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel "crummy" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.


VAERS ID: 1700856 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-08-24
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Death, Diarrhoea, Dyspnoea, Endotracheal intubation, Intensive care, Nausea, Positive airway pressure therapy, Respiratory failure, SARS-CoV-2 test positive, Vomiting, Withdrawal of life support
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (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), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-13
   Days after onset: 20
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 MDI PRN, Apixaban 5 mg QD, Bumetanide 2 mg QD,
Current Illness:
Preexisting Conditions: A-Fib, CHF, CAD, Type 2 DM, Hyperlipidemia, Hypertension, Rheumatoid arthritis, Obstructive sleep apnea
Allergies: Methylprednisolone (itching)
Diagnostic Lab Data: COVID-19 Positive Test on 9/5/2021 using PCR based methods
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status


VAERS ID: 1700861 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-10
Onset:2021-09-10
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19 pneumonia, Cardiac arrest, Chest X-ray abnormal, Death, Intensive care, Pneumonia, Positive airway pressure therapy, Sepsis
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (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 (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 4
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: HTN, CAD
Allergies: NKA
Diagnostic Lab Data: 9/10/2021 Chest x ray: multilobar pneumonia
CDC Split Type:

Write-up: Hospitalized and died. COVID-19 pneumonia. IV Remdesivir and Decadron; IV antibiotics, CCU, BiPap with setting of 16 over 10 with rate 12 and FiO2=80%; Severe sepsis; Acute kidney injury, cardiac arrest.


VAERS ID: 1700902 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-02
Onset:2021-09-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acidosis, Alanine aminotransferase increased, Anion gap, Aspartate aminotransferase increased, Blood glucose increased, Blood potassium decreased, Carbon dioxide decreased, Cardiac arrest, Death, Fall, General physical health deterioration, Hepatic enzyme increased, Resuscitation, Seizure, Troponin, Unresponsive to stimuli, Ventricular fibrillation, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rx for hydroxyzine and sertraline but lat dose unsure
Current Illness:
Preexisting Conditions: Anxiety, elevated BP w/o diagnosis of HTN
Allergies: penicillins (hives, swelling)
Diagnostic Lab Data: 9/14/21 at ED: white cell count 13.50, K 3.3, acidosis with CO2 of 11 and anion gap of 19. Elevated liver enzymes with SGOT of 585 and SGPT 554. Glucose 341. Troponin 0.095
CDC Split Type:

Write-up: Patient had no outstanding medical history but anxiety. Per her husband, patient rapidly declined since receiving the first dose of Moderna COVID19 vaccine on 9/2/21. Patient was seen falling to the ground and having a "seizure" and then becoming unresponsive on 9/14/21. EMS found the patient to be in ventricular fibrillation cardiac arrest. Patient was brought to ED with CPR in progress. At ED, 45 minutes of resuscitative effort was done without ROSC. Time of death called at 1504.


VAERS ID: 1700908 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-10
Onset:2021-03-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Death, Decreased appetite, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-01
   Days after onset: 49
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rytary, acetaminophen, sertraline, Mucinex, miralax, clozapine, fludrocortisone, gas-x, folic acid, B12, allopurinol, vitamin C, atorvastatin, multi-vitamin, D3, azelastine, donepezil, zonisamide
Current Illness: Parkinsons
Preexisting Conditions: Parkinsons, strokes, blood clot
Allergies: Haldol, Reglan, Ativan, ibuprofen, aspirin, naproxen, general anesthesia
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden inability to walk, Hospice was called in, they determined probably only had months to live. Stopped speaking and eating April 25, 2021, and passed away on May 1, 2021.


VAERS ID: 1703517 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-16
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, COVID-19, Cardiac arrest, Chest X-ray, Chest X-ray abnormal, Computerised tomogram, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Death, Dyspnoea, Hypoxia, Intensive care, Lung infiltration, Mechanical ventilation, Oxygen saturation, Oxygen saturation decreased, Positive airway pressure therapy, Productive cough, Pulmonary embolism, SARS-CoV-2 test, SARS-CoV-2 test positive, Tachypnoea, Vaccination failure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Lack of efficacy/effect (narrow), Interstitial lung disease (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, venous (narrow), 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), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-02
   Days after onset: 17
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: CLARINEX-D 24-HOUR; NASACORT; PERCOCET-5; ECOTRIN; PRAVASTATIN
Current Illness: Degenerative joint disease; Hyperlipidemia; Obesity; Penicillin allergy; Sinus disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210716; Test Name: COVID-19 virus test; Result Unstructured Data: positive; Test Date: 20210727; Test Name: Oxygen saturation; Result Unstructured Data: 86 %; Test Date: 20210727; Test Name: CXR; Result Unstructured Data: bilateral infiltrate''s patient was hypoxic and tachypneic; Test Date: 20210731; Test Name: CT scan; Result Unstructured Data: pulmonary embolism; Test Name: Computerised tomogram thorax; Result Unstructured Data: unknown
CDC Split Type: USJNJFOC20210832915

Write-up: DEATH; CARDIAC ARREST; PULMONARY EMBOLISM; HYPOXIA; COVID-19 INFECTION; LUNG INFILTRATION; ANTICOAGULANT THERAPY; CHEST X-RAY ABNORMAL; COMPUTERISED TOMOGRAM THORAX ABNORMAL; CONTINUOUS POSITIVE AIRWAY PRESSURE; DYSPNOEA; INTENSIVE CARE; MECHANICAL VENTILATION; OXYGEN SATURATION DECREASED; PRODUCTIVE COUGH; TACHYPNOEA; SARS-COV-2 TEST POSITIVE; SUSPECTED CLINICAL VACCINATION FAILURE; This spontaneous report received from a health care professional via a Regulatory Authority [VAERS FDA Inbound Unit] concerned a 59 year old male unspecified race and ethnicity. Initial information was processed along with the additional information received from Central Complaint Vigilance on 17-Aug-2021 The patient''s height, and weight were not reported. The patient''s concurrent conditions included: Degenerative joint disease of the spine, hyperlipidemia, obesity, sinus problems, and penicillin allergy. The patient experienced drug allergy when treated with codeine for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: UNKNOWN) dose was not reported, 1 in total administered on 26-FEB-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Concomitant medications included acetylsalicylic acid, acetylsalicylic acid/oxycodone hydrochloride/oxycodone terephthalate, desloratadine/pseudoephedrine sulfate, pravastatin and triamcinolone acetonide for drug used for unknown indication. On 16-JUL-2021, the patient''s laboratory data included COVID-19 virus test (NR: not provided) which was positive and had covid-19 infection. On 27-JUL-2021, the patient had lung infiltration, pulmonary embolism, hypoxia, anticoagulant therapy, chest x-ray abnormal, computerized tomogram thorax abnormal, continuous positive airway pressure, dyspnoea, intensive care, mechanical ventilation, oxygen saturation decreased, productive cough, tachypnoea, and was hospitalized. Laboratory data included: chest x-ray(CXR) (NR: not provided) which shown bilateral infiltrate''s. On 27-JUL-2021, the patient was admitted in hospital intensive care unit with shortness of breath, productive cough and oxygen saturation on 86%. On 31-JUL-2021, the patient had more shortness of breath and was on continuous positive airway pressure high flow and CT of the chest was done showing pulmonary embolism (PE). Treatment medications included: heparin. The patient was put on heparin drip and was decompensated, was connected to minute volume (MV) and went to cardiac arrest, and the patient had passed at 09:57 on 02-AUG-2021. The cause of death was cardiac arrest. It was unknown if autopsy was performed. The patient was hospitalized for 7 days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of cardiac arrest, death, pulmonary embolism, hypoxia, covid-19 infection, lung infiltration, sars-cov-2 test positive, anticoagulant therapy, chest x-ray abnormal, computerised tomogram thorax abnormal, continuous positive airway pressure, dyspnoea, intensive care, mechanical ventilation, oxygen saturation decreased, productive cough and tachypnoea on 02-AUG-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Other Medically Important Condition). This report was associated with product quality complaint: 90000189962. The suspected product quality complaint has been confirmed to be non voided as the reported allegation could not be confirmed, and a manufacturing related root cause could not be identified based on the PQC evaluation/investigation performed. Additional information received from Central Complaint Vigilance department on 13-SEP-2021. The following information was updated and incorporated into the case narrative: Product quality complaint investigation result.; Sender''s Comments: V1: The follow up adds about product quality complaint investigation result. This follow up information does not alter the causality of previously reported events. 20210832915-Covid-19 vaccine ad26.cov2.s- Death,cardiac arrest, pulmonary embolism, hypoxia, covid-19 infection, lung infiltration, sars-cov-2 test positive, anticoagulant therapy,chest x-ray abnormal, computerized tomogram thorax abnormal, continuous positive airway pressure, dyspnoea, intensive care, mechanical ventilation, oxygen saturation decreased, productive cough and tachypnoea. This event(s) is considered unassessable. The event(s) has an compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210832915- covid-19 vaccine ad26.cov2.s -Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: CARDIAC ARREST


VAERS ID: 1703526 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetic; Kidney disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210918252

Write-up: DEATH; This spontaneous report received from a company representative by social media concerned a 57-year-old male of unspecified race and ethnic origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: diabetic and kidney issues. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: unknown) dose, therapy start date were not reported, 1 total, administered for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient died from unknown cause of death. It was unknown if the autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of death was fatal. This report was serious (Death).; Sender''s Comments: V0: 20210918252-Covid-19 vaccine ad26.cov2.s-Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1703530 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210918407

Write-up: DEATH; THROMBOSIS; This spontaneous report received from a consumer concerned a female over the age of 50 with an unspecified race and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported at the time of vaccination. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown and expiry: unknown) dose not reported with frequency 1 total, start therapy date were not reported used for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the consumer saw a video on you tube (social media) where the patient developed thrombosis post vaccination and also died from an unknown cause of death. It was unknown, if an autopsy was performed. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient died on an unspecified date, and the outcome of thrombosis was not reported. This report was serious (Death, and Other Medically Important Condition). This case, from the same reporter is linked to 20210918494. . .; Sender''s Comments: V0- 20210918407-Covid-19 vaccine ad26.cov2.s- Death, Thrombosis. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1703893 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-26
Onset:2021-06-30
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O4SC21A / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011021A / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, Cardiomyopathy, Death, Toxicologic test normal
SMQs:, Cardiomyopathy (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol, Entresto, Spironolactione
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Negative toxicology, evidence of cardiomyopathy on autopsy
CDC Split Type:

Write-up: Death occurred 7 days after the second dose


VAERS ID: 1703894 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-18
Onset:2021-08-31
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 RA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 RA / -

Administered by: Private       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: 2021-08-31
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CAD WITH PACEMAKER, AAA, AFIB, ANEMIA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: CASE DEVELOPED COVID19 AND DIED


VAERS ID: 1703904 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-22
Onset:2021-09-15
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / SYR

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: 2021-09-15
   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: COVID RELATED DEATH; FULLY VACCINATED


VAERS ID: 1703909 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   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: Tradjenta, Ferrocite, Aripiprazole, Bupropion SR, Carvedilol, Oxybutynin ER, Medroxyprogesterone, Simvastatin, Clonidine, Myrbetriq, Valsartan, Duloxetine
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received vaccine about 130pm on 9/16/21. After the vaccine, the patient waited in the pharmacy for 15 minutes to make sure she did not have a reaction. After that time, she went next door to the restaurant for lunch. About 7pm, the fire marshall came into the pharmacy requesting information about the patient. He was aware that she had just received the vaccine at our pharmacy and was inquiring because she went into cardiac arrest while at restaurant. After life-saving measures by EMT, patient was brought in to Medical Center and shortly after, passed away


VAERS ID: 1703921 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-01-28
Onset:2021-09-15
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 - / SYR

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: 2021-09-15
   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: COVID RELATED DEATH; FULLY VACCINATED


VAERS ID: 1703924 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-22
Onset:2021-09-01
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0016M20A / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest pain, Death, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CARDIOVASCULAR DISEASE, DEMENTIA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: DEVELOPED COVID19 WITH SYMPTOM ONSET 8/19 (MUSLCE ACHES, WEAKNESS, SORE THROAT, CHEST PAIN) AND DIED


VAERS ID: 1703929 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-23
Onset:2021-09-03
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis, Computerised tomogram thorax, Confusional state, Endotracheal intubation, Gastric haemorrhage, Haemoglobin decreased, Hepatic cirrhosis, Hypotension, Intensive care, Respiratory distress, Septic shock, Transfusion
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Toxic-septic shock conditions (narrow), Dementia (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-06
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is a 76-year-old Laotian male with reported cirrhosis of the liver, whom we are consulted on for septic shock. All history was obtained from the ICU RN & from the chart, given the patient is intubated. Was driving down to another State. He presented to the ER on 9/3 with generalized weakness and abdominal pain. In the ER, he was hypotensive & confused. CT C/A/P demonstrated cirrhosis of the liver & suspected gastric bleeding. GI was consulted for an EGD, however, the patient was too unstable to undergo endoscopy, hence this procedure had to be canceled. Initial Hgb was 9.7. Unknown baseline. He was transfused. Placed on pressors. He was intubated for respiratory distress.


VAERS ID: 1703941 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-08-19
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / -

Administered by: Private       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: 2021-08-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CONGESTIVE HEART FAILURE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: DEVELOPED COVID19 (ONSET AND DETAILS UNKNOWN, LOST TO FOLLOWUP) AND DIED


VAERS ID: 1703960 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-30
Onset:2021-09-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   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: Personal history of Venous Thrombosis
Preexisting Conditions: Personal history of Venous Thrombosis, Anxiety, Nightmare Disorder, Explosive Anger Disorder, Opioid Abuse Amphetamine Substance Abuse
Allergies: No Known Drug Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bilateral leg pain, history of venous thrombosis.


VAERS ID: 1704016 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-08-18
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19 pneumonia, Death, Respiratory failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), 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), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-24
   Days after onset: 6
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: presented with pneumonia due to COVID, respiratory failure, acute kidney injury, discharged to hospice where he died


VAERS ID: 1704039 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-05
Onset:2021-09-16
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 - / 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: 2021-09-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID RELATED DEATH; FULLY VACCINATED


VAERS ID: 1704056 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-09
Onset:2021-08-11
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Confusional state, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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: 2021-08-27
   Days after onset: 16
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: diagnosed with COVID on 8/11/21; went to hospital on 8/16/21 with SOB, weakness, fever, confusion; hx of chronic kidney disease, type 2 diabetes


VAERS ID: 1704077 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-09-05
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Palpitations, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 0
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: PALPITATIONS (HS OF A FIB), POSITIVE COVID TEST, ACUTE RESPIRATORY FAILURE


VAERS ID: 1704104 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-04
Onset:2021-08-19
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, General physical health deterioration, Hyperkalaemia, Lung disorder, SARS-CoV-2 test positive
SMQs:, Guillain-Barre syndrome (broad), Chronic kidney disease (broad), Tumour lysis 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: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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: presented to ED with weakness and hyperkalemia; admitted to hospital; positive COVID test on 8/24; bilat air space disease, condition declined


VAERS ID: 1704111 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-23
Onset:2021-08-20
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, COVID-19, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Death, Diarrhoea, Dyspnoea, General physical health deterioration, Hypervolaemia, Multiple organ dysfunction syndrome, Nausea, Paracentesis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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 (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), 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: 2021-09-15
   Days after onset: 26
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: hepatocellular carcinoma, COPD, hepatitis C
Preexisting Conditions: hepatocellular carcinoma, COPD, hepatitis C
Allergies: lisinopril, iodine based contrast
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had known recent covid infection on 8/20/21. Admitted to hospital on 9/7/21 with SOB, abdominal distension and nausea, vomiting and diarrhea. Paracentesis was performed on 9/8 and 9/13 for continued abdominal swelling. Increasing need for 02 supplement due to swelling/volume overload. Chest xray worsening. Was being treated with combivent nebs and symibcort for COPD exacerbation and zosyn. Continued to decline with multiorgan compromise. Elected transition to comfort care and passed on 9/15.


VAERS ID: 1704209 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-08-27
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Diarrhoea, Dyspnoea, End stage renal disease, Haemodialysis, Hypervolaemia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (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: 2021-08-29
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload


VAERS ID: 1704228 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-26
Onset:2021-08-19
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Chronic kidney disease, Malaise, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), 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), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-02
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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 on 8/19/21; presented to ED with generalized malaise, rhinorrhea, fever; acute hypoxic respiratory failure; acute renal failure superimposed on CKD stage 4


VAERS ID: 1704256 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-08-14
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Infusion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (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: 2021-08-31
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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: positive COVID test 8/14/21; presented to ED from infusion center where she had been receiving antibody infusions since 8//18/21; complains of increasing chills, fever, cough, SOB, diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID


VAERS ID: 1704279 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-01
Onset:2021-09-16
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-16
   Days after onset: 0
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: multiple hospitalizations for chronic diseases
Preexisting Conditions: CVA, cardiac disease, diabetic, encephalopathy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid vaccine dose #1 2/10/2021 Moderna Lot # 024m20A dose #2 3/1/2021, Moderna, lot # n/a pt died on 9/16/2021 in the hospital from cardiac arrest, aspiration, prolonged hospitalizations for chronic illnesses, not a covid related death.


VAERS ID: 1704289 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-02
Onset:2021-09-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Private       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: 2021-09-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, metoprolol, rosuvastatin, amlodipine, hydrochlorothiazide, gapapentin, cyclobenzaprine, omega 3 fatty acid
Current Illness:
Preexisting Conditions: hyperlipidemia, hypertension, chronic pain, smoker
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: sudden death


VAERS ID: 1704317 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-28
Onset:2021-08-14
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Infusion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (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: 2021-09-06
   Days after onset: 23
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: positive COVID test on 8/14/21; presented to ED from infusion center where she''s been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID


VAERS ID: 1704342 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-09
Onset:2021-06-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-15
   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: Unknown
Current Illness: Unknown
Preexisting Conditions: Obesity
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Just sick as per family.


VAERS ID: 1704443 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-08-15
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dyspnoea
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), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-28
   Days after onset: 13
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: presented with worsening SOB; pneumonia due to COVID; acute hypoxemic respiratory failure


VAERS ID: 1704452 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04DC21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Movement disorder, Pain
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad)

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? No
Previous Vaccinations:
Other Medications: no
Current Illness: unknown
Preexisting Conditions: respiratory
Allergies: unknown
Diagnostic Lab Data: awaiting medical examiner report.
CDC Split Type:

Write-up: my daughter was complaining of loss of movement in both arms and legs, along with pain, approximately 1 hour after administration of the second dose of Moderna. she took tylenol, and went to sleep at approxiamately 5 pm, and never woke back up.


VAERS ID: 1704464 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-08-28
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dyspnoea, Exposure to SARS-CoV-2, Oropharyngeal pain
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), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   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: presented with increasing SOB, sore throat; husband diagnosed with COVID earlier in week; patient positive for COVID; HX of A Fib; pneumonia due to COVID; acute hypoxemia respiratory failure


VAERS ID: 1704467 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-05
Onset:2021-06-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-12
   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: Naltrexone and bupropion
Current Illness: Pilonidal abscess draining
Preexisting Conditions: Depression, Previous alcohol abuse, and obesity
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Not feeling well and headaches


VAERS ID: 1704478 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-08-22
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Hypoxia, 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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: presented with weakness; COVID positive; acute hypoxemia respiratory failure


VAERS ID: 1704505 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-01
Onset:2021-08-27
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19 pneumonia, Death
SMQs:, 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: 0
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient died 8/27/2021 at the Hospital with diagnosis of Pnuemonia caused by SARS-CoV-2


VAERS ID: 1704514 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-22
Onset:2021-03-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Myocardial infarction, Stent placement, Vascular stent thrombosis
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-15
   Days after onset: 54
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, HTZ, Levothyroxine, vitamin D
Current Illness: none
Preexisting Conditions: Pacemaker since age 44 for 3rd degree heart block
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had heart attack 7 weeks post 2nd dose of COVID vaccine on May 11. Had STENT placed the next morning on May 12. Died the morning of May 15 which was to be her discharge home morning. Death certificate says STENT thrombosis. Never had any Hx of CAD.


VAERS ID: 1704515 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-09-13
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 2
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: Diagnosed 9/13/2021. Cycle threshold 19.5.
CDC Split Type:

Write-up: Hospitalization due to COVID19. Reported per Moderna COVID vaccine EUA.


VAERS ID: 1704518 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-08-19
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Hypoglycaemic coma, Pyrexia, SARS-CoV-2 test positive, Seizure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (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), Convulsions (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presented to ED with seizure due to hypoglycemic coma; hx of type 2 diabetes, CVA; experienced fever, positive COVID test; pneumonia due to COVID, with hypoglycemic coma and secondary acute hypoxemia respiratory failure


VAERS ID: 1704534 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-09-10
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   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: chronic AFib on rivaroxaban, frequent falls, dyslipidemia, CAD s/p stent, prior CVA, hypertension, COPD, chronic hypoxic respiratory failure on 3 L home oxygen, depression, chronic pain, GERD, hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to hospital after exposure to household cooking gas (gas leak) on 9/10/21 Tested positive for COVID-19 on 9/11/21 Noted to have COPD and chronic respiratory failure which required 3 Liters of Oxygen per minute at home. Patient expired on 9/15/21


VAERS ID: 1704542 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-30
Onset:2021-08-17
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea, Hypoxia, Lung infiltration, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), 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 (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
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 for COVID on 8/17/21; presented to ED with increasing dyspnea; hypoxic, chest with severe bilateral infiltrates; pneumonia due to COVID


VAERS ID: 1704564 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-07-30
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0011M20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, Death, Deep vein thrombosis, General physical health deterioration, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 33
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presented with acute respiratory failure, COVID positive; hx of type 2 diabetes, CHF, COPD; developed acute lower extremity DVT and A Fib with RVR while in hospital; pt''s condition declined; was admitted to long term care facility where he died


VAERS ID: 1704600 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-12
Onset:2021-08-07
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-15
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes mellitus, Chronic renal disease, high blood pressure, autoimmune condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died of covid related causes.


VAERS ID: 1704688 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-08-12
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19, Cough, Dyspnoea, Endotracheal intubation, Mechanical ventilation, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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: 2021-09-06
   Days after onset: 25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 25 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presented with cough and increasing dyspnea; positive for COVID; hx of granulomatous polyangiitis and airway strictures; ARDS with intubation, mechanical assistance


VAERS ID: 1704749 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-18
Onset:2021-03-20
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Condition aggravated, Death, Fatigue, Feeling abnormal, Lung neoplasm malignant, Radiotherapy
SMQs:, Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 174
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: N/A
Preexisting Conditions: Cancer in Remission for many years
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I am the coordinator for the facility. She started to have problems after the first dose of the vaccine. There was also a lot of fatigue and feeling poorly. Her condition got worse after the second dose of the vaccine and she saw her doctor. It was discovered that she was in the final stage of Lung cancer. She had two treatments of radiation and then it was advised that she receive Hospice Care. She passed away shortly after that.


VAERS ID: 1705032 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-10
Onset:2021-08-31
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal X-ray, Abdominal pain, Arteriosclerosis, Blood glucose decreased, Blood pH decreased, COVID-19, Chest X-ray normal, Coeliac artery stenosis, Death, Endotracheal intubation, Explorative laparotomy, Gastrointestinal disorder, Gastrointestinal tube insertion, Grimacing, Haemoglobin decreased, Hypoglycaemia, Hypotension, Ileus, Imaging procedure abnormal, Intensive care, Intestinal ischaemia, Mesenteric arterial occlusion, Mydriasis, Procedural failure, Resuscitation, SARS-CoV-2 test positive, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Dyskinesia (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (narrow), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-02
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, baclofen, clopidogrel, dicyclomine, ibuprofen, metoprolol succinate, ocrevus, pravastatin, entresto, trazodone
Current Illness:
Preexisting Conditions: ? Hyperlipidemia ? Hypertension ? Coronary artery disease ? Chronic airway obstruction, not elsewhere classified ? Multiple sclerosis (CMS/HCC) ? Arthritis ? Cardiomyopathy (CMS/HCC) ? Stented coronary artery ? ICD (implantable cardioverter-defibrillator) in place ? VT (ventricular tachycardia) (CMS/HCC) ? Pericardial effusion ? Pericarditis ? Left ventricular pseudoaneurysm ? Former smoker ? H/O acute myocardial infarction ? Bilateral carotid artery stenosis ? PVD (peripheral vascular disease) with claudication (CMS/HCC) ? Peripheral vascular disease with claudication (CMS/HCC) ? Chronic systolic heart failure (CMS/HCC) ? PAD (peripheral artery disease) (CMS/HCC) ? Radiculopathy of lumbosacral region ? Dehydration ? Diabetes mellitus (CMS/HCC) Ischemic colitis
Allergies: Interferons, latex
Diagnostic Lab Data: 8/31/21 COVID19: positive 8/31/21 Chest xray: negative 9/2/21 xray abdomen: NG tube placement into the stomach with multiple loops of dilated small bowel. This is thought to be related to an ileus rather than obstruction however correlation the patient''s clinical presentation would be of benefit
CDC Split Type:

Write-up: Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications. There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted. Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021.


VAERS ID: 1706486 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921454

Write-up: DEATH; This spontaneous report received from a consumer via a company representative through social media concerned 3 patients of unspecified age, sex, race and ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: unknown and expiry date: unknown) dose, start therapy date were not reported, 1 total, administered for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. The reporter stated that, "3 patients died from the Janssen vaccine" (date unspecified). The cause of death was unknown. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of event death was fatal. This report was serious (Death).; Sender''s Comments: V0: 20210921454-Covid-19 vaccine ad26.cov2.s-Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706511 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 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: USJNJFOC20210923692

Write-up: DEATH; SUDDENLY STOPPED BREATHING; This spontaneous report received from a consumer concerned a 34 year old female of unknown race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, Expiry: Unknown) dose was not reported, 1 total, administered on unspecified date in AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified in AUG-2021, after one week of vaccination, the patient suddenly stopped breathing at home. The patient was trying to be brave and tough it out and she decided not to go to the emergency room (ER). On an unspecified date in 2021, the patient died from unknown cause of death at home. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died on 2021, and the outcome of suddenly stopped breathing was not reported. This report was serious (Death, and Other Medically Important Condition). This case, from the same reporter is linked to 20210921562.; Sender''s Comments: V0: 20210923692-covid-19 vaccine ad26.cov2.s -Death, Suddenly stopped breathing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706517 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Intracardiac thrombus, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210923766

Write-up: BLOOD CLOT IN HEART; SUSPECTED COVID-19 INFECTION; SUSPECTED CLINICAL VACCINATION FAILURE; This spontaneous report received from a consumer via social media concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, start therapy date were not reported, 1 total administered for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient died from getting covid (suspected covid-19 infection and suspected clinical vaccination failure) and having a blood clot in heart. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected clinical vaccination failure was not reported. This report was serious (Death, and Other Medically Important Condition). This report was associated with product quality complaint (PQC).; Sender''s Comments: V0.20210923766-covid-19 vaccine ad26.cov2.s -blood clot in heart, suspected Covid 19 infection. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210923766-covid-19 vaccine ad26.cov2.s -suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: BLOOD CLOT IN HEART; SUSPECTED COVID-19 INFECTION


VAERS ID: 1706519 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Vaccination failure, Vaccine breakthrough infection
SMQs:, Lack of efficacy/effect (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: Multimorbidity
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210923788

Write-up: DEATH; BREAKTHROUGH INFECTION; SUSPECTED CLINICAL VACCINE FAILURE; This spontaneous report received from a consumer via a company representative concerned a male of unspecified age. Initial information was processed along with the additional information received on 14/Sep/2021. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: comorbidities. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin and batch number not reported, expiry: unknown) dose, start therapy date were not reported, administered 1 total for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient experienced breakthrough infection after vaccination (suspected covid 19 infection) and suspected clinical vaccine failure. On an unspecified date, the patient died from unknown cause It was unspecified if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death on an unspecified date, and the outcome of breakthrough infection and suspected clinical vaccine failure was not reported. This report was serious (Death, and Other Medically Important Condition). This case is associated with product quality complaint number 90000193360; Sender''s Comments: V0: 20210923788-COVID-19 VACCINE AD26.COV2.S-Death, Breakthrough infection. These events are considered unassessable. The events have a compatible/suggestive temporal relationship, are unlabeled, and have unknown scientific plausibility. There is no information on any other factors potentially associated with the events. 20210923788-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706528 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210924012

Write-up: DEATH; BLOOD CLOTS; This spontaneous report received from a consumer via social media via a company representative concerned three patients of unspecified age, sex, race and ethnic origin. The patient''s weight, height, and medical history were not reported. The patient received Covid-19 vaccine (suspension for injection, route of admin not reported, batch number: unknown, expiry: unknown) dose, start therapy date were not reported, 1 total was administered for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, (days after getting vaccine) the 3 patient''s had blood clots and they died from unknown cause of death. It was unspecified if an autopsy was performed. The action taken with Covid-19 vaccine was not applicable. The patient''s died from unknown cause of death, and the outcome of blood clots was not reported. This report was serious (Death, and Other Medically Important Condition).; Sender''s Comments: V0: 20210924012-COVID-19 VACCINE -Death, Blood clots. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706534 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210924142

Write-up: DEATH; This spontaneous report received from a consumer via social media concerned a male of unspecified age and unknown race and ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) 1 total, dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, after vaccination, the patient died in his apartment shortly from an unknown cause of death. It was unspecified if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0: 20210924142 -COVID-19 VACCINE AD26.COV2.S-Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706543 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Death, Feeling abnormal, Haemorrhage, Laboratory test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-07
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: Laboratory test; Result Unstructured Data: Not provided
CDC Split Type: USJNJFOC20210924439

Write-up: DEATH; HEMORRHAGING AND BLEEDING; FELT BAD; BACK PAIN; This spontaneous report received from a patient via a company representative concerned a 37 year old female of an unspecified race and ethnic origin. The patient''s weight height and medical history were not reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry date: Unknown) dose was not reported, 1 total administered on 02-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-SEP-2021 (Saturday), the patient experienced back pain and felt bad and went to the emergency room. She had tests run and was then sent home. On 05-Sep-2021, she developed hemorrhaging and bleeding and ambulance returned for her. On 07-Sep-2021, she died due to unknown cause. It was not reported, if the autopsy was performed or not. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death on 07-SEP-2021, and the outcome of feeling bad, back pain and hemorrhaging and bleeding was not reported. This report was serious (Death, and Other Medically Important Condition).; Sender''s Comments: V0: 20210924439-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Death, Hemorrhaging and bleeding. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1706571 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210925910

Write-up: BLOOD CLOTS; This spontaneous report received from a consumer via a company representative from social media concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose were not reported,1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, it was reported as ''''Hi Scientist! Explain why a friend of mine died a week after getting the J & J Vax with blood clots..'''' The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0-20210925910-COVID-19 VACCINE AD26.COV2.S-Blood Clots(Fatal). This event is considered un-assessable. The event has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.; Reported Cause(s) of Death: BLOOD CLOT


VAERS ID: 1706576 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210925983

Write-up: THREE DEATHS; This spontaneous report received from a consumer via a company representative via social media concerned 3 multiple patients. The patient''s weight, height, and medical histories were not reported. The patients received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified dates, the 3 multiple patients experienced deaths. As per the reporter, "Well, investigations happened and so far, three deaths in total have been confirmed, connected to the J and J vaccine. On an unspecified dates, the 3 multiple patients died from unknown cause of death. It was unknown whether autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0:20210925983-CDOVID-19 VACCINE AD26.COV2.S-Three deaths. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1707311 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-05-12
Onset:2021-05-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 00C21A / 1 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Dyspnoea, Hemiparesis, Seizure, Tongue movement disturbance
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-13
   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: Emphysema (little); Smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiopulmonary resuscitation; Stroke (Consumer previously had a stoke in his 30''s.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Had a massive stoke; Convulsions; Gasping for breath; Lost function of left side of bod; Couldn''t take tongue out of mouth; This spontaneous case was reported by a consumer and describes the occurrence of CEREBROVASCULAR ACCIDENT (Had a massive stoke), SEIZURE (Convulsions), DYSPNOEA (Gasping for breath), HEMIPARESIS (Lost function of left side of bod) and TONGUE MOVEMENT DISTURBANCE (Couldn''t take tongue out of mouth) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 00C21A) for COVID-19 vaccination. The patient''s past medical history included Stroke (Consumer previously had a stoke in his 30''s.) and Cardiopulmonary resuscitation. Concurrent medical conditions included Emphysema (little) and Smoker. On 12-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-May-2021, the patient experienced CEREBROVASCULAR ACCIDENT (Had a massive stoke) (seriousness criteria death and medically significant), SEIZURE (Convulsions) (seriousness criteria death and medically significant), DYSPNOEA (Gasping for breath) (seriousness criterion death), HEMIPARESIS (Lost function of left side of bod) (seriousness criteria death and medically significant) and TONGUE MOVEMENT DISTURBANCE (Couldn''t take tongue out of mouth) (seriousness criterion death). The patient died on 13-May-2021. The cause of death was not reported. An autopsy was not performed. No Concomitant medication was reported. No treatment medications were reported. Patient had a massive stoke, convulsions, gasping for breath, lost function of left side of body, and couldn''t take tongue out of mouth on 13May2021. Wife noticed the symptoms of stoke and called 911 immediately. While on the phone with dispatcher, wife performed CPR and used mouth to mouth technique on her husband for up to 20 minutes. Wife stated they shocked the patient to bring back but it was unsuccessful and patient passed away on 13May2021 in wife''s arms. Patient was on heavy blood thinners. Company Comment: Very limited information regarding these events has been provided at this time. The fatal outcome may be related to the patient''s pre-existing comorbidities. Further information required.; Sender''s Comments: Very limited information regarding these events has been provided at this time. The fatal outcome may be related to the patient''s pre-existing comorbidities. Further information required.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1707498 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: A lady died after getting their second Moderna shot; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (A lady died after getting their second Moderna shot) in a 6-decade-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Death occurred on an unknown date The cause of death was not reported. It is unknown if an autopsy was performed. Concomitant medications were not reported. No treatment details were provided. Company Comment - Very limited information regarding this event has been provided at this time. Further information is not expected as no consent for follow up was obtained.; Sender''s Comments: Very limited information regarding this event has been provided at this time. Further information is not expected as no consent for follow up was obtained.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1708239 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-25
Onset:2021-09-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727ER8727 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Culture negative, Death, Endotracheal intubation, Hyperkalaemia, Hypophagia, Hypotension, Intensive care, Mechanical ventilation, Mental status changes, Skin disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (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), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), 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: 2021-09-15
   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: Patient was admitted to Hospital for acute hypoxic respiratory failure secondary to COVID-19 infection and acute kidney injury on 09/05/2021. Patient was started on dexamethasone he was also anticoagulated with heparin given AKI. Acute kidney injury suspected to be prerenal secondary to poor oral intake in the setting of COVID-19 infection patient was also taking several medications at home such as Lasix and lisinopril. Patient required of supplemental oxygenation and fell heated high-flow nasal cannula to refractory hypoxemia then required noninvasive positive pressure ventilation. He continued to become more hypoxic and MRT was called 9/7/21 for hypoxia with oxygen saturation in the 70s and change in mental status. Decision was made to intubate the patient. At this time patient was transferred out of the ICU on mechanical ventilation. He continued to have worsening acute kidney injury and hyperkalemia which point nephrology was consulted and decision was made to start CRRT. Concern for superimposed bacterial infection and patient''s antibiotics were escalated to cefepime and vancomycin, no growth on cultures. Patient also required norepinephrine intermittently throughout the admission for hypotension. Patient continued to remain hypoxic despite mechanical ventilation requiring paralytics, proning and was also on nitric oxide. Nitric oxide was stopped and protein was also stop later of the admission due to skin breakdown. Fluid removal per CRRT given concerns for volume overload. Family decided to withdraw care transition to comfort measures only. Patient passed shortly after with family at bedside. Time of death 1435 September 15, 2020


VAERS ID: 1708241 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-01
Onset:2021-07-26
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Death, Exposure to SARS-CoV-2, Mechanical ventilation, Renal failure, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (narrow)

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

Write-up: PUI is at Ave. PUI was fully vaccinated however wife indicated why she was out of town he was exposed by someone and upon her return he was found non-responsive. He currently is in critical condition on a ventilator and currently experiencing kidney failure. Prognosis is not good. Patient died.


VAERS ID: 1708245 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-04
Onset:2021-08-26
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac arrest, Cardio-respiratory arrest, Endotracheal intubation, Malaise, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (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), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 82-year-old white male who presents to the emergency room via emergency traffic with CPR in progress. Patient was a witnessed arrest at home. Patient just finished his 10 day isolation for COVID-19 yesterday but was still very ill apparently according to the wife. CPR was started within approximately 5 minutes of patient''s witnessed arrest. Initial rhythm on scene per EMS was asystole. Patient was intubated at the field with a 8 0 ET tube and IO in the right leg was placed. And route patient received 3 rounds of epinephrine and CPR. Upon arrival here at the emergency room a total length of time over 15-20 minutes has been performed on the patient and the patient is still in asystole as he is wheeled into room.


VAERS ID: 1708279 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-09
Onset:2021-09-15
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K2OA / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Cerebral artery perforation, Cerebral infarction, Cerebral mass effect, Cerebral thrombosis, Cerebral vascular occlusion, Cerebral ventricle collapse, Death, Differential white blood cell count, Full blood count, Haematoma, Haemorrhagic transformation stroke, Mastoid disorder, Metabolic function test, Mucosal hypertrophy, Periorbital haematoma, Sinusitis, Troponin I, White matter lesion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COMPREHENSIVE METABOLIC PANEL GLUCOSE BY METER, POCT LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL TROPONIN I Icon Imaging Orders Placed Today Imaging Tests CT HEAD WITHOUT CONTRAST CT SPINE CERVICAL WITHOUT CONTRAST EKG XRAY CHEST PORTABLE -
CDC Split Type:

Write-up: DEATH! FINDING: Posterior right scalp hematoma. Additional right frontal/periorbital scalp hematoma. Mild scattered mucosal thickening in the paranasal sinuses. Air-fluid level in the right maxillary sinus. Mastoids aerated. Motion artifact limits evaluation of the globes and orbits, within this limitation the appear unremarkable. Calvarium intact. Low-density change involving nearly the entire left frontal lobe, left basal ganglia, left insula, anterior left parietal lobe, and superior left temporal lobe. There is associated loss of gray-white differentiation and is consistent with an acute to subacute subacute infarct. Measurements are approximately 4.7 x 11.0 cm. Foci of hyperdensity noted centrally within the tissue measuring up to 1.4 x 1.5 cm likely represents small amount of hemorrhage/hemorrhagic conversion. This involves both the left ACA and left MCA territories. Question hyperdensity within the left MCA. There is mass effect with sulcal effacement, compression of the left frontal horn/left lateral ventricle, and 2.5 mm rightward midline shift. IMPRESSION: 1. Large acute to subacute infarct measuring up to 4.7 x 11.0 cm involving nearly the entire left frontal lobe, left basal ganglia, left insula, superior left temporal lobe, and anterior left parietal lobe. This involves both the left anterior cerebral artery and left middle cerebral artery territories. 2. Foci of hyperdensity centrally within the infarcted tissue is consistent with hemorrhage/hemorrhagic conversion. Largest focus of hemorrhage measures up to 1.5 cm. 3. Together these findings contribute to mass effect with sulcal effacement, compression left lateral ventricle, and 2.5 mm rightward midline shift. 4. Question hyperdense left MCA, presents potentially representing vascular occlusion or intravascular thrombus. CTA or MRA could provide further characterization. 5. Posterior right and right frontal/periorbital scalp hematomas.


VAERS ID: 1708406 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-30
Onset:2021-07-31
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Death
SMQs:, Anaphylactic reaction (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: 30
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 25 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Hypertension, Immunosuppressive condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was fully vaccinated. he PUI says that the only symptom that he has had was a cough. The PUI is currently in the hospital but it is not covid related. Patient died due to COVID-19 on 8/30/2021.


VAERS ID: 1708500 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-08-24
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Death, Dyspnoea, General physical health deterioration, SARS-CoV-2 test positive, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (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: 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt''s condition deteriorated and died in the hospital


VAERS ID: 1708627 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-03
Onset:2021-02-02
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-13
   Days after onset: 160
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: olmesartan, Crestor, Plavix
Current Illness: none
Preexisting Conditions: cardiovascular disease
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: within a month started having shortness of breath, fatigue, and chest discomfort


VAERS ID: 1708656 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-18
Onset:2021-07-29
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Death, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-17
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes Hypertension Cardiovascular condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath or difficulty breathing Chest pain Fatigue or tiredness Hospitalization and death


VAERS ID: 1708661 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-05
Onset:2021-02-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Laboratory test, 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: 2021-04-07
   Days after onset: 51
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: COPD, CKD, RA.
Allergies: NKA
Diagnostic Lab Data: Covid test, CXR, labwork.
CDC Split Type:

Write-up: Pt came to ER c/o difficulty breathing.


VAERS ID: 1708822 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-09-10
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Agitation, Asthenia, Blood culture negative, Blood lactic acid increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Cognitive disorder, Condition aggravated, Cough, Culture urine negative, Culture urine positive, Death, Delirium, Dementia, Hypomagnesaemia, Hypoxia, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sepsis, Systemic inflammatory response syndrome, Tremor, Urinary incontinence, Urinary tract infection, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 5
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: adapalene (DIFFERIN) 0.1 % gel Ascorbic Acid (VITAMIN C PO) aspirin 81 MG chewable tablet atorvastatin (LIPITOR) 80 MG tablet B Complex-C (SUPER B COMPLEX PO) benzonatate (TESSALON) 100 MG capsule Cholecalciferol (VITAMIN D3) 2000 UNITS TAB
Current Illness: Hospital admission 9.6.21 - 9.8.21: diagnosis - SIRS; hypomagnesemia; recent UTI (COVID negative during this hospitalization) Worsened and COVID-19 positive 9.10.21
Preexisting Conditions: OSA on CPAP Polyneuropathy in diabetes Essential hypertension HLD (hyperlipidemia) Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin Actinic keratosis Medial meniscus, posterior horn derangement, right Mild dementia NSTEMI (non-ST elevated myocardial infarction) Coronary artery disease involving native coronary artery of native heart with other form of angina pectoris Cardiomyopathy, ischemic Shortness of breath Lower abdominal pain Pneumonia due to COVID-19 virus Generalized weakness Metabolic encephalopathy Advanced care planning/counseling discussion Acute respiratory failure with hypoxia
Allergies: Ranexa [Ranolazine]
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization (9.10.21) --- $g patient deceased (9.15.21) due to COVID-19 pneumonia; COVID-19 positive 9.10.21; fully vaccinated Date of Death: 9/15/21 Time of Death: 1:29 PM Preliminary Cause of Death: Pneumonia due to COVID-19 virus Discharge Disposition: expired DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus COVID-19 HOSPITAL COURSE: 74 yo male presented with the complaint of fever and weakness. He had been admitted on 9/6/21 with fever and weakness and had tested negative for covid. He had a UTI and was discharged home on the 8th. He returned 2 days later and was positive for covid and had hypoxia with CXR findings. He was admitted for the treatment of covid pneumonia dn started on dexamethasone. Over the course of his stay his baseline dementia was worse with note sun downing and associated agitation. He did not like having oxygen on or pulse ox monitoring. Family stayed with him which did not help. They decided to change his goals of care and talked to hospice. He was changed to comfort care and passed away with his family at bedside. (at admission: HISTORY OF PRESENT ILLNESS: Patient is a 74 y.o. male who presents today with fever and weakness . Recently discharged 9/8/2021 with febrile illness meeting sepsis criteria with elevated lactic, wbc, fever . Started with empiric abx With zosyn. Infectious work up neg for covid, film array , cxr, blood and urine cultures neg . Op urine culture growing serratia. He improved clinically and was dc to complete x2 more days cipro. Per wife still having low grade fever on dc . He progressively became more generally weak . continued with higher fever and chills taking tylenol for relief. With fever and weakness brought back in to ed where tested pos for covid 19 . In ed lactic elevated initially then trended down . Per wife he has become more and more wean . Still able to stand and walk to bathroom . Notes increasing urine incontinence now utilizing depends. No co chest pain and really has not been sob significantly . Minimally cough. No dysuria other wise . No diarrhea . No co ha vision changes. Notes progressive decline in cognitive function over last several months. occasionally wit hand tremors . No other sz like movements .)


VAERS ID: 1708831 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-01-22
Onset:2021-09-03
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 2 LA / 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: 2021-09-12
   Days after onset: 9
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: DMII
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed, hospitalized and expired with COVID 19- fully vaccinated


VAERS ID: 1708865 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-12
Onset:2021-09-17
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient death.


VAERS ID: 1708959 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-09-03
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cephalexin, latanoprost ophthalmic
Current Illness:
Preexisting Conditions: arthritis
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient recently discharged from Hospital for COVID pneumonia. Patient symptoms did not improve and came to our faciliy on 9/3. Patient''s respiratory status deteriorated. Family consented to DNR. Patient expired 9/15/21.


VAERS ID: 1709442 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 3 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Breath sounds abnormal, Cardiomegaly, Cellulitis, Chest X-ray abnormal, Death, Erythema, Full blood count, Hypotension, International normalised ratio increased, Lymphocyte percentage decreased, Neutrophil percentage increased, Oxygen saturation decreased, Pain, Petechiae, Platelet count decreased, Pleural effusion, Pneumonia, Pulmonary congestion, Red cell distribution width increased, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: 2021-09-17
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen Tablet 500 MG 2 tablet by mouth three times a day, Artificial Tear Ointment Instill 1 ribbon in right eye at bedtime, Cetirizine HCl Tablet 5 MG give 1 tablet by mouth one time a day, Coumadin Tablet 1 MG every day, Fluticaso
Current Illness: Resident was exhibiting times of increased confusion. He was being treated for chronic conditions including bilateral lower extremity bilateral lower extremity edema.
Preexisting Conditions: He had resided in the nursing home since July, 2011. He required extensive assist for most ADLS. He was on long term use of anticoagulant due to pulmonary embolism, atrial fibrillation. His other diagnosis include chronic kidney disease, COPD, DM, venous insufficiency, macular degeneration, aortic insufficiency.
Allergies: No Known Allergies
Diagnostic Lab Data: 9/5 and 9/16/21- CXR 9/5/21 CXR indicated developing pneumona and worsening basilar aeration (compared to 2/2021 CXR). 9/16/21 CXR indicated the heart is modestly enlarged. mild pulmonary venous congestion and slight bilateral pleural effusions. A CBC was done on 9/7/21- WBC elevated at 12.4, RDW elevated at 15.6, PLT low at 125, NE% high at 88.9, and LY% low at 4.6.
CDC Split Type:

Write-up: Resident was noted to have a low blood pressure on 9/4/21 89/47 and oxygen was less than 90% with usual supplemental oxygen at 2L. On 9/5/21 oxygen need was increased to 5-6LPM for saturations in the low 80s and redness and petechia was noted to his left leg. (Was already being treated for venous insufficiency in right leg). On 9/6/21 the resident was started on antibiotics (Levofloxacin) for pneumonia with pleural effusion. Daily INRs were initiated due to use of antibiotics and chronic Coumadin use. Coumadin was given on alternate days of the antibiotic. On 9/9 the INR was 5.4 and on 9/10 the INR was 5.8. He received a one time dose of Vitamin K. On 9/11/21 he was started on Doxycycline for cellulitis. He continued to decline and had decreased lung sounds. The resident was noted to have increase in pain and was started on morphine on 9/13/21. The resident passed away on 9/17/21.


VAERS ID: 1709467 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 91301 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Death
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   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: nicotine 21 mg/24 hr daily transdermal patch, Ventolin HFA 90 mcg/actuation aerosol inhaler, prednisone 20 mg tablet, albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization, Advair Diskus 500 mcg-50 mcg/dose powder for inhalation
Current Illness: asthma exacerbation, drug overdose
Preexisting Conditions: asthma, tobacco use, methamphetamine abuse, tobacco use disorder
Allergies: NKA
Diagnostic Lab Data: pending coroner report
CDC Split Type:

Write-up: Patient came in after an ER visit for a reported intentional opioid overdose. She was doing ok at the visit, some minor wheezes on exam. She had requested refills on meds and reported having worsening asthma after her first shot but no ER visits. We decided to give her the second moderna shot due to her high risk should she contract covid 19 and sent her home with a course of prednisone in case of exacerbation. RN administered injection and had her wait in the room after the visit per protocol, patient was doing fine and was sent home. We found out several days later she passed away at home according to a coroners report of reported possible asthma exacerbation versus drug overdose, still being investigated. coroner reported finding drug paraphernalia at the scene and case is pending tox screen results.


VAERS ID: 1709844 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-01
Onset:2021-08-01
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Cerebrovascular accident, Death, Intensive care, Intentional removal of drug delivery system by patient, Magnetic resonance imaging head abnormal
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), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-26
   Days after onset: 25
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: He took blood pressure medication and insulin
Current Illness:
Preexisting Conditions: Diabetes, high blood pressure
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: My father went to thr hospital for knee pain and was admitted to the ER same day saying he had COVID. He spent 4 days in ER and was then transferred to local ICU. After a couple days he was released from ICU into a room in the hospital. At somepoint here, he was sedated by hospital staff because they said he was taking tubes out of his body and stuff. He never came too after be sedated, and was moved back to the ICU. Another few days passed with no one havimg a clue what was going on and finally MRI was conducted MRIs by the doctor revealed ''numerous strokes in his brain.'' He died on August 26, 2021


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