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From the 1/21/2022 release of VAERS data:

Found 22,607 cases where Vaccine targets COVID-19 (COVID19) and Patient Died

Government Disclaimer on use of this data



Case Details

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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: 1939112 (history)  
Form: Version 1.0  
Age: 81.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-25
Onset:2021-09-14
   Days after vaccination:173
Submitted: 2021-09-14
   Days after onset:0
Entered: 2021-09-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK LA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Cough, Death, Dyspnoea, General physical health deterioration, Hypercapnia, Hypoxia, Mental status changes, Positive airway pressure therapy, Respiratory failure
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), Dementia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   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: N/A
CDC Split Type:

Write-up: Patient is a 81 y.o with PMH of T2DM, HTN, HLD, BPH, and obesity who presented for dyspnea, and cough found to have COVID pneumonia initially admitted to hospital for AHRF d/t COVID-19. MICU consulted for rapidly progressing respiratory failure requiring high flow oxygen with AMS. Continued to be hypoxic with mild hypercarbia, so started on BIPAP. Discussed GOC with family and patient. They elected to make patient DNR/DNI due to his poor prognosis, advanced age and underlying dementia. Patient''s condition continued to deteriorate and he expired on 9/14/2021, approximately 2 weeks after hospital admission.


VAERS ID: 1947387 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-27
Onset:2021-09-01
   Days after vaccination:5
Submitted: 2021-09-15
   Days after onset:14
Entered: 2021-09-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 3 LA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chronic obstructive pulmonary disease, Cough, Death, Dyspnoea, Musculoskeletal chest pain, Nausea, Painful respiration, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 0
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
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: Narrative: Patient received Moderna COVID vaccine #1 on 4/20/21. On 8/4/21, he was seen in a ER for shortness of breath and COPD and was discharged. On 8/8/21, he was seen in our ER with c/o right anterior chest wall pain with coughing and breathing x 6 days. He was found to have a pneumonia and admission was recommended; however he was signed out AMA instead and was given a RX for Augmentin and ibuprofen. On 8/27/21, he was seen in the GI clinic for nausea of unknown origin and this same day he also received COVID #2 vaccine. On 9/1/21, it was reported by his wife that he passed away at home. No autopsy report available. There were 5 days from time of second vaccine to date of death.


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


VAERS ID: 1709850 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-24
Onset:2021-04-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: No adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   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: Blood pressure, Insulin, Gabapentin, venafaxaline
Current Illness: Afib, Diabetes, Neuropathy, High blood pressure
Preexisting Conditions:
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: No symptoms


VAERS ID: 1710217 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-02-23
Onset:2021-03-22
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 1 - / SC

Administered by: Military       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: furosemide rifaximin aspirin hydromorphone
Current Illness: none
Preexisting Conditions: Metastatic Liver Cancer
Allergies: Paroxetine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Death


VAERS ID: 1710785 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-05-23
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Blood creatine phosphokinase, Chest X-ray, Chest X-ray abnormal, Death, Intensive care, Metabolic function test, Microbiology test, Pneumonia, Rhabdomyolysis, SARS-CoV-2 test, Sepsis, Sputum culture
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), 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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-24
   Days after onset: 1
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: MECLIZINE [MECLOZINE]; ZYRTEC [CETIRIZINE HYDROCHLORIDE]; AZITHROMYCIN
Current Illness: Acute kidney injury; Bilateral pneumonia; Penicillin allergy; Rhabdomyolysis; Sepsis; Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: AFib; Benign lung neoplasm; Hyperlipidemia
Allergies:
Diagnostic Lab Data: Test Date: 20210523; Test Name: Comprehensive metabolic panel; Result Unstructured Data: not reported; Test Date: 20210523; Test Name: Microbiology test; Result Unstructured Data: not reported; Test Date: 20210523; Test Name: Chest X-ray; Result Unstructured Data: abnormal; Test Date: 20210523; Test Name: Sputum culture; Result Unstructured Data: not reported; Test Date: 20210523; Test Name: SARS-CoV-2 test; Result Unstructured Data: not reported; Test Date: 20210524; Test Name: Comprehensive metabolic panel; Result Unstructured Data: not reported; Test Date: 20210524; Test Name: Microbiology test; Result Unstructured Data: not reported; Test Date: 20210524; Test Name: Chest X-ray; Result Unstructured Data: abnormal; Test Date: 20210524; Test Name: Sputum culture; Result Unstructured Data: not reported; Test Date: 20210524; Test Name: SARS-CoV-2 test; Result Unstructured Data: not reported; Test Name: Creatine kinase; Result Unstructured Data: Unknown
CDC Split Type: USJNJFOC20210927103

Write-up: DEATH; RHABDOMYOLYSIS; ACUTE KIDNEY INJURY; SEPSIS; PNEUMONIA; INTENSIVE CARE; CHEST X-RAY ABNORMAL; METABOLIC FUNCTION TEST; MICROBIOLOGY TEST; SARS COV-2 TEST; SPUTUM CULTURE; This spontaneous report was received from literature via a Regulatory Authority Vaccine Adverse Event Reporting System (VAERS) (VAERS ID 1391630), concerned an 86 year old male. The objective of the study was to better understand the underlying pathomechanism and to investigate whether subcutaneous injection of vaccines may be able to prevent rhabdomyolysis. The patient''s height, and weight were not reported. The patient''s past medical history included: atrial fibrillation (AFib), hyperlipidemia and tumor in lungs, and concurrent conditions included: penicillin allergy, sulfa drug allergy, severe sepsis, bilateral pneumonia, acute kidney injury, and rhabdomyolysis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: unknown and expiry date: unknown) dose was not reported, 1 total, administered on 20-MAY-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 azithromycin, cetirizine hydrochloride, and meclozine. On 23-MAY-2021 (3 days after vaccination), the patient was found down in his home and admitted to Intensive care unit (ICU) from the emergency room (ER) with severe sepsis, bilateral pneumonia, acute kidney injury and rhabdomyolysis. On 23-MAY-2021 and 24-MAY-2021 Laboratory data included: chest X-ray abnormal, comprehensive metabolic panel, microbiology test, SARS-CoV-2 test, and sputum culture. The patient was hospitalized for two days. Laboratory data (dates unspecified) included: Creatine kinase (NR: not provided) Unknown. On 24-MAY-2021, the patient died from unknown cause of death. It was unspecified if an autopsy was performed. Author stated that it remained unclear whether the development of acute kidney failure in patient was due to the vaccine or was multicausal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died on 24-MAY-2021, the outcome of rhabdomyolysis, acute kidney injury, sepsis, pneumonia, intensive care, chest x-ray abnormal, metabolic function test, microbiology test, SARS-CoV-2 test and sputum culture was fatal. The author emphasized that physicians should be aware of the possibility of vaccine-induced rhabdomyolysis as a potentially serious side-effect in patients complaining of myalgia following vaccination, particularly in times of mass vaccinations. Patients may be advised to monitor the color of their urine for the early detection of rhabdomyolysis. Finally, the article report suggests the need for aggressive fluid resuscitation and close monitoring for the prevention of acute kidney failure in patients with rhabdomyolysis. This report was serious (Death, Life Threatening, and Hospitalization Caused / Prolonged). This case, from same Literature article is linked to 20210528518, 20210922810, 20210922823, 20210543394, 20210924285, 20210914711, 20210924327, 20210705289, 20210721677, 20210757800, 20210762171, 20210905291, 20210923028, 20210923039, 20210528129, 20210702722 and 20210705289.; Sender''s Comments: V0:20210927103-JANSSEN COVID-19 VACCINE Ad26.COV2.S - Death, rhabdomyolysis, acute kidney injury, sepsis, pneumonia, intensive care, chest x-ray abnormal, metabolic function test, microbiology test, sars cov-2 test ,sputum culture - 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: 1711125 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Georgia  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Product contamination physical
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: three people died; the flakes of rubber and little pieces of steel found in the vials; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DEATH (three people died ) and PRODUCT CONTAMINATION PHYSICAL (the flakes of rubber and little pieces of steel found in the vials) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced DEATH (three people died) (seriousness criteria death and medically significant) and PRODUCT CONTAMINATION PHYSICAL (the flakes of rubber and little pieces of steel found in the vials) (seriousness criterion death). The cause of death was not reported. It is unknown if an autopsy was performed. No concomitant product was reported. No treatment medication was reported. This case concerns a patient with no details on age, gender and past medical history, who presented with unexpected event of death on an unknown date after receiving the second dose of mRNA 1273 vaccine. It is unknown if an autopsy was performed. Product contamination physical was considered as an additional event. The event was considered related to the product per the reporter''s assessment. The benefit risk relationship of vaccine is not affected by this report. Reporter did not allow further contact; Sender''s Comments: This case concerns a patient with no details on age, gender and past medical history, who presented with unexpected event of death on an unknown date after receiving the second dose of mRNA 1273 vaccine. It is unknown if an autopsy was performed. Product contamination physical was considered as an additional event. The event was considered related to the product per the reporter''s assessment. The benefit risk relationship of vaccine is not affected by this report.; Reported Cause(s) of Death: unknown cause of death


VAERS ID: 1711555 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-16
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101139074

Write-up: a friend of hers that died on 16Apr21; This is a spontaneous report received from a contactable consumer and downloaded from the Regulatory Authority, regulatory authority number ES-AEMPS-972586. This consumer reported for a 90-year-old male patient (friend) who received bnt162b2 (Formulation:Solution for injection, Batch/Lot number was not reported, Expiry date: unknown), via an unspecified route of administration on an unspecified date as dose number unknown, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The consumer reported a friend of hers (patient) that died on 16Apr2021. He got his vaccine at the same time her husband did, but she is unsure if it was Pfizer. It was not reported if an autopsy was performed. The outcome of the event was fatal. The lot number for the vaccine, (BNT162B2), was not provided and will be requested during follow up.; Reported Cause(s) of Death: She also mentioned a friend of hers that died on 16Apr2021.


VAERS ID: 1711576 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101142118

Write-up: received the covid-19 vaccine and died; This is a spontaneous report. A contactable consumer reported for a male patient (reporter''s cousin) of an unspecified age received bnt162b2 (COVID-19 VACCINE - MANUFACTURER UNKNOWN), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient received the COVID-19 vaccine and died on an unspecified date. The reporter stated that "All the vaccines have Graphene oxide and that is what is killing people. Some countries are not giving any vaccines at this time. His cousin received the COVID-19 vaccine and died, but is not sure which vaccine his cousin had. None of the CEO''s have had the COVID-19 vaccine, and that this is genocide." It was unknown if an autopsy was performed. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.; Reported Cause(s) of Death: received the covid-19 vaccine and died


VAERS ID: 1711622 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101145863

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1711685 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101151190

Write-up: his friend died 2 weeks after receiving Pfizer Vaccine; This is a spontaneous report from a non-contactable consumer via Pfizer-sponsored program. A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE ; lot number and expiration date was not reported), via an unspecified route of administration on an unspecified date at unknown dose number, single for covid-19 immunization. The patient medical history was not reported. There were no concomitant medications. Reporter stated that his friend died 2 weeks after receiving pfizer vaccine. Reporter wanted to know if vaccine was agency approved. Also wanted to know what the threshold was for number of people dying before Vaccine was pulled from market. It was not reported if an autopsy was performed. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Clarified caller knows his friend died 2 weeks after receiving Pfizer Vaccine


VAERS ID: 1711707 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101152212

Write-up: died in his sleep; This is a spontaneous report from a non-contactable consumer. A 23-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On an unspecified date, the patient died in his sleep (death). The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: died in his sleep


VAERS ID: 1711841 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 RT-PCR test; Result Unstructured Data: Test Result:contracted COVID
CDC Split Type: USPFIZER INC202101169144

Write-up: Received BNT162B2 and it was longer than 7 days after their 2nd dose that they contracted COVID-19/Patient was vaccinated and contracted COVID-19; Received BNT162B2 and it was longer than 7 days after their 2nd dose that they contracted COVID-19/Patient was vaccinated and contracted COVID-19; This is a spontaneous report from a non-contactable consumer. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection), on an unspecified date (lot number was not reported) as dose 1, single; then on an unspecified date (lot number was not reported) as dose 2, single - both via an unspecified route of administration for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was reported that the patient received BNT162B2 and it was longer than 7 days after their 2nd dose that they contracted COVID-19 on an unspecified date. The patient was vaccinated and contracted COVID-19 who died with it and they were young. The patient underwent COVID-19 RT-PCR test: contracted COVID, positive on an unspecified date. The patient died due to COVID-19 and drug ineffective. It was unknown if an autopsy was performed or not. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Drug ineffective; COVID-19


VAERS ID: 1711875 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101171328

Write-up: neurosurgeon who received the Pfizer COVID-19 vaccine died immediately after administration; This is a spontaneous report from a non-contactable consumer. A patient of unspecified age and gender received BNT162B2 (Pfizer-BIONTECH COVID-19 Vaccine), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) dose number unknown, single, for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was reported that the patient neurosurgeon who received the Pfizer COVID-19 vaccine died immediately after administration on an unspecified date. The patient died on an unspecified date. The cause of death was unknown. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about the lot/batch number could not be obtained. No further information is expected.; Reported Cause(s) of Death: neurosurgeon who received the Pfizer COVID 19 vaccine and died immediately after administration


VAERS ID: 1711880 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101172210

Write-up: Died; This is a spontaneous report from a contactable consumer reporting the same event under the same suspect product for three patients. This is one of three reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for Covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient died on an unspecified date. It was unknown if an autopsy was performed. The lot number for the vaccine (BNT162B2) was not provided and will be requested during follow-up.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101172300 Same reporter/product/event; different patient.; PFIZER INC-202101172301 Same reporter/product/event; different patient.; Reported Cause(s) of Death: Died


VAERS ID: 1711881 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101172300

Write-up: died; This is a spontaneous report from a contactable consumer reporting the same event under the same suspect product for three patients. This is one of three reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for Covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient died on an unspecified date. It was unknown if an autopsy was performed. The lot number for the vaccine (BNT162B2) was not provided and will be requested during follow-up.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101172210 Same reporter/product/event; different patient.; PFIZER INC-202101172301 Same reporter/product/event; different patient; Reported Cause(s) of Death: died


VAERS ID: 1711882 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101172301

Write-up: died; This is a spontaneous report from a contactable consumer reporting same event under the same suspect product for three patients. This is one of three reports. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient died on an unspecified date. It was not reported if an autopsy was performed. The lot number for BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101172300 Same reporter/product/event; different patient; PFIZER INC-202101172210 Same reporter/product/event; different patient; Reported Cause(s) of Death: died


VAERS ID: 1711885 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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: Medical History/Concurrent Conditions: Diabetes; Overweight
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101175692

Write-up: died after getting one dose of the pfizer covid 19-vaccine; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age (reported as 57) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose 1 , single for COVID-19 immunisation. Medical history included overweight and diabetes, from an unknown date. The patient''s concomitant medications were not reported. On an unspecified date, the patient died after getting one dose of the Pfizer COVID 19-vaccine, was not specific if it was due to the vaccine. The patient died on an unspecified date. Outcome of the event was fatal. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: died after getting one dose of the pfizer covid 19-vaccine


VAERS ID: 1711892 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101176612

Write-up: died after taking a Covid vaccine; This is a spontaneous report. A non-contactable consumer reported that a patient (reporter''s cousin) of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced died after taking a covid vaccine on an unspecified date. This report was reported as non-serous by reporter. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: died after taking a Covid vaccine


VAERS ID: 1711915 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101178096

Write-up: die from this; This is a spontaneous report from a contactable consumer (friend). This consumer reported similar events for two patients. This is the first of two reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient died from this on an unspecified date in 2021. The patient died on an unspecified date in 2021. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101178224 same reporter/drug/event, different patient.; Reported Cause(s) of Death: die from this


VAERS ID: 1711923 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-08-28
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   Days after onset: 29
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101181997

Write-up: flu like symptoms; This is a spontaneous report from a contactable consumer (patient''s brother). A 49-year-old patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 28Aug2021 (Batch/Lot number was not reported) as dose 1, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient started experiencing flu like symptoms on Aug2021, which only got worse for the next few days. He passed away Monday, 30Aug2021. His death was extremely unexpected since he was feeling great before the Pfizer vaccine. The patient died on 30Aug2021. It was not reported if an autopsy was performed. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Reported Cause(s) of Death: flu like symptoms


VAERS ID: 1711978 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anger, Bipolar disorder, Completed suicide, Hostility, Personality change
SMQs:, Suicide/self-injury (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bipolar disorder (Verbatim: Yes bipolar. It exacerbated it); COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101189604

Write-up: he was angry at everyone and committed suicide; whole personality changed.; He became so hositle; he was angry at everyone and committed suicide; bipolar, it exacerbated it.; This is a spontaneous report from a contactable consumer (patient). A 43-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 20Mar2021 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunisation. Medical history included bipolar, it exacerbated it. The patient had covid prior vaccination. No known allergies. No other vaccine in four weeks. The patient received other medications in two weeks. Adverse event start date reported as 20Mar2021. From receiving second dose whole personality changed. All of a sudden he was picking fights with everyone. He went from being passive aggressive to arguing over politics religions and anything he could find. It did not matter. It got to the point his own family did not know him. He became so hostile that he by the end of the summer he was angry at everyone and committed suicide 29Aug2021. The events resulted in Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. The events were reported as life threatening illness (immediate risk of death from the event) and disability or permanent damage. The events received treatments. The patient did not test covid post vaccination. The outcome of events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1711982 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Pericardial effusion
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101190033

Write-up: He was hospitalized and then he died.; fluid around his heart; This is a spontaneous report from a non-contactable consumer via a Pfizer sponsored program COVAX support. A 31-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 for Covid-19 Immunization. The patient was hospitalized and then he died. The doctor said the fluid around his heart was a direct symptom of the Pfizer Covid-19 vaccine. The outcome of event died was fatal and fluid around his heart was unknown. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: He was hospitalized and then he died


VAERS ID: 1712001 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191074

Write-up: died the beginning of this month because of blood clots because of vaccine.; This is a spontaneous report from a Pfizer-sponsored program COVAX Support. A contactable consumer reported for a patient of unspecified age and gender received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced died the beginning of this month because of blood clots because of vaccine on an unspecified date. The patient died in Sep2021. It was not reported if an autopsy was performed. The lot number for [BNT162B2], was not provided and will be requested during follow up.; Reported Cause(s) of Death: died the beginning of this month because of blood clots because of vaccine.


VAERS ID: 1712010 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Exposure via breast milk
SMQs:, Neonatal exposures via breast milk (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-09
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191908

Write-up: baby yesterday that died because its breastfeeding mother got the vaccine and its been linked back to the vaccine.; baby yesterday that died because its breastfeeding mother got the vaccine and its been linked back to the vaccine.; This is a spontaneous report from a contactable consumer or other non-healthcare professional. A patient of unspecified age and gender received unknown dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported), via transmammary on an unspecified date as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The reporter wanted to know the data for the risks, adverse reactions, and side effects associated with the Pfizer-BioNTech Covid-19 Vaccine. She wanted to know the exact percentage of each. She also wants to know information about blood clots, and deaths associated with the vaccine. She said there was a baby yesterday that died because its breastfeeding mother got the vaccine and its been linked back to the vaccine. The reporter said she has rheumatoid arthritis, and was on Embrel, and Methotrexate. She wants to know the possible interaction and risks of her medications and condition with the Pfizer-BioNTech Covid-19 Vaccine. The reporter wanted the complete list, and the breakdown of the ingredients for the approved Comirnaty, and the approved Pfizer-BioNTech Covid-19 Vaccine. The baby died on 09Sep2021. It was not reported if an autopsy was performed. The outcome of the event was fatal. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Reported Cause(s) of Death: baby yesterday that died because its breastfeeding mother got the vaccine and its been linked back to the vaccine.


VAERS ID: 1712070 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / OT

Administered by: Senior Living       Purchased by: ?
Symptoms: Carcinoid tumour pulmonary, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Non-haematological malignant tumours (narrow), Hypokalaemia (broad)

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: ALPRAZOLAM; ONDANSETRON; CLARITIN; CLOPIDOGREL; SENNA; ALBUTEROL SULFATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Failure to thrive
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198162

Write-up: Hx malignant Carinoid tumor of the Bronchus; Lung-Hx of Respiratory Failure; This is a spontaneous report from a contactable nurse. An 89-year-old female non-pregnant patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), at the age of 89-years-old intramuscular, administered in Arm Left on 09Sep2021 11:00 (Lot Number: 301358A) as single dose for covid-19 immunisation. Medical history included failure to thrive. No known allergies. No COVID prior vaccination. No COVID tested post vaccination. No other vaccine in four weeks. Concomitant medication(s) included alprazolam; ondansetron; clarithromycin (CLARITIN); clopidogrel; sennoside a+b (SENNA); albuterol sulfate. It was reported resident expired 24 hours after COVID vaccination, death causes were hx malignant carinoid tumor of the bronchus, lung-hx of respiratory failure. The adverse event start date and time was reported as 10Sep2021 14:45. No treatment was received. The patient died on 10Sep2021. An autopsy was not performed.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the events Carcinoid tumor pulmonary (fatal) Respiratory failure (Fatal) and BNT162B2. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate. ; Reported Cause(s) of Death: Lung-Hx Of Respiratory Failure; Hx malignant Carinoid tumor of the Bronchus


VAERS ID: 1712073 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198237

Write-up: died from the vaccine; This is a spontaneous report from a non-contactable consumer from a Pfizer sponsored program. An unspecified age and gender patient received the first dose of BNT162B2 via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. Medication history included and concomitant medication were not reported. On an unspecified date, the patient was died from the vaccine. Caller was a consumer who was interested in receiving the FDA-approved BNT162B2 vaccine and is asking where can she get it. Caller said that in their area, the BNT162B2-labeled vaccine is not available. In addition to that, caller said that her employer wants them to be vaccinated. Caller also expressed her feeling of being uncomfortable in receiving "experimental vaccine" since she does not know what are the side effects and she also mentioned that someone in her family died from the vaccine after the first dose in which that someone never woke up again from sleep and was previously healthy and no medical issues. Caller said that since it is approved already, it should be available and not mislead people in getting the experimental vaccine. Caller said the line kept "breaking up" and could not hear properly. Autopsy was not reported. The outcome of event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: died from the vaccine.


VAERS ID: 1712074 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198393

Write-up: had the shot and within 3 hours started having seizures and have died within 24 hours; Caller also know a friend''s son that had the shot and within 3 hours started having seizures and have died within 24 hours.; This is a spontaneous report received from contactable consumer from a Pfizer sponsored program COVAX support via medical information team. A male patient of an unspecified age received bnt162b2 (COMIRNATY, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experienced caller also knows a friend''s son that had the shot and within 3 hours started having seizures and have died within 24 hours. Reporter wants to know if what studies have been done with the vaccine if they were tested in animals and other studies being conducted. Reporter also asked where she can find information about the trial conducted with the vaccine from the start before EUA. Reporter is a consumer who wants to know what is in the shot. Reporter is asking how Comirnaty is FDA-approved when it is still on clinical trial. Reporter said she felt she is being rushed over. Reporter said that there are a lot of misleading information and now on political disaster. Reporter said that the issues with the vaccine are being suppressed. Reporter said issues about the vaccine are being suppressed such as issue with bell''s palsy. Reporter mentioned that she according to the nurse where her mother is currently admitted; they see a 50-60% of hospitalization among vaccinated people. Reporter also know a friend''s son that had the shot and within 3 hours started having seizures and have died within 24 hours. In addition to that, reporter know someone whose both parents on their 60s got the shot that has heart attack and the other on pacemaker. Reporter said no underlying issues before except for one with an issue with blood pressure. Reporter also know another friend with a heart working at 18% since the 90s and on medication who is on the donor list for a new heart that received the vaccine. Reporter said that the heart dropped below and is on around 12% then they took her off from the donor list. Reporter also knew 3 young women in their 20s that have been vaccinated as well. The one is hemorrhaging in the hospital while the two other has blood clots and the one suspected to be pregnant has a miscarriage. Their period has also become messed up that became longer and heavier with cramping and nausea and vomiting. Another one she knows is someone before the shot has no problem on getting pregnant but now cannot get pregnant. Reporter said that these are all the reasons why she is afraid to get the vaccine. Transferring agent stated, I have a consumer on the line that is reporting an adverse event for the Pfizer COVID-19 Vaccine. So, she said that one of the nurses in the hospital, say they see 50 to 60 percent of hospitalization that are vaccinated (Further Clarifications Unknown) and she also reports that her friend''s son had the shot and in just 3 hours, he started having issues (Further clarifications unknown hence event captured as per verbatim) in like within 28 hours and she also somewhat (Incomplete sentence) (Further Clarifications Unknown). The patient died on an unspecified date. It was not reported if an autopsy was performed. Outcome of the events was fatal. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up. Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: seizures


VAERS ID: 1712081 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101202095

Write-up: passed away; This is a Spontaneous report Facilitated Collect based on the information received by Pfizer. A contactable consumer (wife) reported a male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications was not reported. The patient experienced passed away on an unspecified date. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are needed; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1712128 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Virginia  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101211957

Write-up: a couple that die from COVID and left 5 kids behind; This is a spontaneous report from a Pfizer-sponsored program Pfizer.com - General Company Information via a contactable consumer. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at an unknown dose via an unknown route on an unknown date for COVID-19 immunization. The patient medical history and concomitant medications were not reported. A couple died from COVID and left 5 kids behind. The patient died on an unspecified date. It was not reported if an autopsy was performed. The lot number for the vaccine, [BNT162B2] was not provided and will be requested during follow-up.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101212055 same reporter, same event, drug/ different patient; Reported Cause(s) of Death: a couple that die from COVID and left 5 kids behind


VAERS ID: 1712130 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101212055

Write-up: A couple die from COVID and left 5 kids behind; This is a spontaneous report from a contactable consumer. A patient of an unknown age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at an unknown dose via an unknown route on an unknown date for Covid-19 immunization. Medical history and concomitant drug were not provided. A couple died from COVID and left 5 kids behind. Patient knew the family. Outcome of the event was fatal. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101211957 same reporter, same event, drug/ different patient; Reported Cause(s) of Death: a couple that die from COVID.


VAERS ID: 1712149 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215416

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died in the US, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712150 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215906

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712151 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215907

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712152 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215908

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712153 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215909

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died in the US, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712154 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215910

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died in the US, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712155 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215911

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712156 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101215912

Write-up: I personally know 9 people who died from your vaccination; This is a spontaneous report from a non-contactable consumer reporting same event under the same suspect product for 9 patients. This is one of 9 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Reporter stated, "I personally know 9 people who died from your vaccination. You reported 16,000 people have died, even the people who work for the company speaking on this." It was unknown if autopsy was done. The outcome of the event was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101145863 Same reporter/drug/event, different patient.; Reported Cause(s) of Death: died from your vaccination


VAERS ID: 1712704 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acidosis, Acute respiratory failure, Atrial fibrillation, Bacterial infection, Blood culture negative, COVID-19, COVID-19 pneumonia, Cardio-respiratory arrest, Chest X-ray abnormal, Cough, Death, Dyspnoea, Echocardiogram, Echocardiogram normal, Ejection fraction, Electrocardiogram normal, Endotracheal intubation, Intensive care, Lung infiltration, Mechanical ventilation, Oxygen saturation decreased, Prone position, Pulse absent, Pyrexia, Resuscitation, SARS-CoV-2 test positive, Sepsis, Ultrasound Doppler normal, Ultrasound scan normal, Vaccine breakthrough infection, White blood cell count
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-12
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 24 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 20 MG Oral Tablet Take 1 tablet by mouth daily. 4/19/21 Blood Glucose Monitoring Suppl Does not apply Device Monitor BG daily. 12/29/20 BLOOD GLUCOSE TEST STRIPS VI Strip 1 strip by In Vitro route daily. 10/
Current Illness:
Preexisting Conditions: Depression, T2DM, HLD, obesity, schizophrenia, anxiety
Allergies: NKDA
Diagnostic Lab Data: SARS-COV-2, NAA, Detected: 08/19/2021
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary: Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked 8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered. Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending. D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid. S/p Ancef for MSSA pneumonia. Progressive Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt''s pulse lost again. Time of death 10:17.


VAERS ID: 1713220 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-17
Onset:2021-09-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 2 LA / IM

Administered by: Senior Living       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: Amlodipine, Seroquel, Morphine, Geri-Lanta, Miralax, Colace, Senna, Ventolin, Combivent, Zofran, Acetaminophen, Geri-Tussin, Benzonatate, MVI
Current Illness: Infection-suspected UTI- Bactrim DS
Preexisting Conditions: Lung CA w/ bone mets
Allergies: NKDA/NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Found dead in restroom about four hours after administration of vaccine. Patient has been rapidly declining w/ Metastatic lung CA.


VAERS ID: 1713242 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-18
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: two days breathing problems, then boom - dead


VAERS ID: 1713249 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death, Deep vein thrombosis, Gait disturbance, Malaise, Pulmonary embolism
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-03
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism.


VAERS ID: 1713331 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-29
Onset:2021-09-12
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient death


VAERS ID: 1713423 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-09
Onset:2021-08-05
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN ZOLAZIA / 1 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-05
   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: Patient was diagnosed with a mild heart arrhythmia. She had a Cardiac Catheterization that resulted in no negative findings. Patient was treated and on regulated medications for high blood pressure. Patient had a check up with her primary Physician whom stated her heart sounded great on 8/2/2021, three days prior to her heart collapse.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Back of heart collapsed.


VAERS ID: 1713447 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-22
Onset:2021-08-01
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown, came in for second vaccine with no known drug history
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patients boyfriend came into the pharmacy on 09/18/21 asking when she received her 2nd dose of the vaccine. I asked if it was because she lost her card and he said "No, she died a few days after and I''m trying to figure out if it was from the vaccine". Date of death/causes/symptoms of death unknown.


VAERS ID: 1713499 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Coronary artery disease, Death, Headache, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   Days after onset: 169
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Patient did blood work 1mo before the vaccine, which reported a healthy heart and overall health. He suffered extreme headaches and ordered bloodwork in early September. That''s when the care team told patient that his heart wasn''t doing well and that he was at risk of an imminent heart attack. He had two heart attacks at the hospital that day, resulting in permanent damage of one of his heart arteries.
CDC Split Type:

Write-up: Severe and continue headaches for months, followed by two heart attacks on Sept 7, resulting in damaged heart artery leading to death on September 17, 2021 at 3AM.


VAERS ID: 1713660 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-03
Onset:2021-03-16
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Cerebral haemorrhage, Cerebrovascular accident, Computerised tomogram, Delirium, Epistaxis, Faecal vomiting, Haematemesis, Headache, Intensive care, Malaise, Mechanical ventilation, Pain, Platelet count decreased, SARS-CoV-2 test negative, Thrombotic thrombocytopenic purpura, Urinary tract infection
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Renovascular disorders (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-24
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Blood work, CT scan
CDC Split Type:

Write-up: After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect. This doctor was in the ICU at hospital.


VAERS ID: 1713892 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-01-08
Onset:2021-01-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebral haemorrhage, Computerised tomogram head abnormal, Death, Headache, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-17
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan Brain Hemorrhaging
CDC Split Type:

Write-up: Developed severe headache the morning of 1/15/21 called for help found unconscious in bed room floor regained consciousness taken to Hospital became unresponsive shortly there after. Result of hemorrhaging on the brain. Died 1/17/21.


VAERS ID: 1714152 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-01-25
Onset:2021-09-08
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Death, Decreased appetite, General physical health deterioration, Interstitial lung disease, Lung opacity, Oxygen saturation decreased, SARS-CoV-2 test positive, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-19
   Days after onset: 11
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: Tylenol PRN, aspirin, refresh tears, vitamin D3, vitamin B12, donepezil, ferrous sulfate, levothyroxine, memantine ER, multivitamin, pantoprazole, pravastatin, quetiapine, sertraline
Current Illness:
Preexisting Conditions: Dementia, depression, diabetic neuropathy, GERD, hypertension, hypothyroid, retinal hemorrhage, skin cancer, tinnitus
Allergies: tetanus
Diagnostic Lab Data: 9/8/21 COVID19: positive 9/13/21 chest xray: Mild patchy opacification interstitial prominence demonstrated. Some of this may be atelectatic, some which may be infectious/inflammatory. 9/14/21 CTA chest: Findings compatible with COVID pneumonia. Right lower lobe airspace disease may relate to COVID pneumonia or potentially to a superimposed community or hospital-acquired pneumonia 9/16/21 US: negative 9/16/21 chest xray: Findings compatible with COVID pneumonia with interval worsening. The potential of developing diffuse alveolar damage/ARDS is considered.
CDC Split Type:

Write-up: Arrived to ER on 9/13/2021. Patient is an 81-year-old female with advanced dementia, diabetes, hypertension, tested positive for COVID on 09/08/2021. Was vaccinated approximately 7 months ago with Pfizer. Has not been eating. Has episodes of desaturation below 90% on room air. Patient unable to provide any history whatsoever. Admitted to hospital on 9/13/21. She started on decadron, keep oxygen above 90%. I covered her with abx due to possible superimposed bacterial GNR PNA. She was tested positive for COVID on 09/08/2021. She was vaccinated approximately 7 months ago with Pfizer. Was started her on remdesivir 9/14; started on doxycycline and ceftriaxone. CTA confirmed Covid-19 PNA and possible superimposed RLL PNA GNR; no signs of PNA. Pt developed acute hypoxic respiratory failure with increasing oxygen requirement on 9/15. She is now on HFNC 60 liters. Niece is aware of deterioration. Ct with supportive measures. Due to worsening of respiratory status. Talked with POA the niece and patient placed on comfort on 9/18. She was on IV prn morphine and IV ativan prn. She passed away on 9/19/21 01:02AM


VAERS ID: 1714227 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-19
Onset:2021-09-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F1A / 1 LA / IM

Administered by: Pharmacy       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: NONT THAT I AM AWARE OF
Current Illness:
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: WIFE CALLED AND SAID HE HAS PASSED


VAERS ID: 1714282 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-24
Onset:2021-02-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Antibody test, Biopsy liver abnormal, Bladder cancer, Bladder catheter temporary, Blood creatine increased, Blood test, Blood urea increased, Chest X-ray abnormal, Computerised tomogram abnormal, Condition aggravated, Cystoscopy normal, Death, Dyspnoea, Fatigue, Flank pain, Haematuria, Haemorrhage urinary tract, Hepatic lesion, Incomplete course of vaccination, Lymphadenopathy, Malaise, Musculoskeletal pain, Nephrostomy, Oxygen saturation decreased, Pneumonia, Pulmonary oedema, Renal scan abnormal, Scan with contrast, Ureteric obstruction
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Renovascular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-07-21
   Days after onset: 144
Permanent Disability? Yes
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: plavix
Current Illness:
Preexisting Conditions: Coronary artery disease Non invasive low grade bladder cancer (under control for 12 years with regular Turbts and BCG )
Allergies: penecillin
Diagnostic Lab Data: Cat Scan 3/8, 4/2 Kidney scan 4/5 Cat Scan 6/21 Plethora of blood work throughout hospital stays Antibody check from vaccine on 4/6- lower antibody levels compared to spouse
CDC Split Type:

Write-up: Received Pfizer 2/24, 24 hours later buttocks cheeks hurt, flank pain started and within 7 days, urinating blood, general feeling unwell, clots became so large they ultimately blocked urine flow completely. Went to ER 3/8, creatine was elevated, did a cat scan which showed enlarged lymph nodes attributed to vaccine hospital said and otherwise unremarkable. Hospital, through a catheter did and aggressive bladder flush and was put on morphine, flushed for 48 hours then had drops in oxygen and labored breathing, x ray showed fluid in lungs, diagnosed with hospital acquired pneumonia from the flush, once on antibiotics and creatine/ bun stabilized, was released. Clots returned in 3-4 days, went to urologist for scope, unremarkable, no invasion of bladder cancer through the wall, recommends another cat scan (3.5 weeks after previous scan ) scan showed enlarged lymph nodes and some liver lesions, recommend biopsy of liver and lymph nodes and kidney scan, both are scheduled. Blot clots get worse, end up in ER 4/18, elevated creatine and bun, urologist tried to do ureter stents, ureters blocked so bilateral nephrostomy tubes were put in. Liver biopsy done 4/20. Dad was stabilized and released with no biopsy results until 4/27, metastatic bladder cancer diagnosis. Oncologist put dad on Keytruda once every 3 weeks. Dad has been feeling unwell since his 1st vaccine, never got the 2nd due to all of these complications. Dad ends up back in hospital on 6/21 with general unwell feeling, fatigue, cat scan shows further progression and because of an error a resident did a cat scan with dye which then added contrast induced nephropathy to the issues. Dad passed away on Wednesday, July 21st at 6:45pm.


VAERS ID: 1714343 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-01
Onset:2021-03-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Lymphadenopathy, Renal failure, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), 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), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 187
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid & beta blocker
Current Illness: None
Preexisting Conditions: Chronic lymphocytic leukemia
Allergies: None
Diagnostic Lab Data: He had numerous medical tests and appointments with Primary care, hematologist, urologist, etc.
CDC Split Type:

Write-up: Increase in White blood count and kidney failure, resulting in death. Increase of white blood cell count went from completely normal to over 100,000 over a couple month time frame. At time of death, he had physically observable lymph nodes swelling all over his body and were nearly bursting from his skin on his belly. He died a horrible in hospice at home.


VAERS ID: 1714418 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-02-09
Onset:2021-03-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Computerised tomogram, Diffuse large B-cell lymphoma
SMQs:, Malignant lymphomas (narrow), Haematological malignant tumours (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 184
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: Flu
Other Medications: Levothyroxine Gabapentin Vit. D Pantoprazole Sodium 1 gram
Current Illness:
Preexisting Conditions: Lower back pain and multiple surgeries
Allergies: NKA
Diagnostic Lab Data: CT scan 8/21/2021 Needle biopsy 8/23/2021
CDC Split Type:

Write-up: Diffuse large B cell lymphoma


VAERS ID: 1714502 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-20
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: USJNJFOC20210928799

Write-up: PASSED AWAY DUE TO BLOOD CLOTS; This spontaneous report received from a consumer via media concerned a couple of multiple patients. The patients'' 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 numbers were not reported and have been requested. No concomitant medications were reported. On an unspecified dates, a couple of patients passed away due to blood clots. As per the reporter, "The called did mention that she was aware of a couple of patients who passed away due to the blood clots as reported by the media (on an unknown date)". On an unspecified dates, the couple of patients died from blood clots. It was unspecified if an autopsy was performed or not. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death). This case, from the same reporter is linked to 20210928678, 20210929077 and 20210929648.; Sender''s Comments: V0:20210928799-covid-19 vaccine ad26.cov2.s-Passed away due to 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: BLOOD CLOTS


VAERS ID: 1714727 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-01-12
Onset:2021-01-04
   Days after vaccination:358
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0724 / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Death, Dyspnoea, Mesothelioma
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-17
   Days after onset: 132
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: Medication for low bone density - unknown name
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: A CT scan revealed cancer (myothelioma) which normally takes several months following diagnosis. Patient died within weeks, from being perfectly healthy prior to her first vaccination.
CDC Split Type:

Write-up: Death following severe breathing difficulties starting shortly after vaccination. Patient had a second vaccination but this was not reported on her vaccine card.


VAERS ID: 1714925 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-25
Onset:2021-09-13
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   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: RNA positive COVID 19
CDC Split Type:

Write-up: Hospitalized for COVID and died as a result of COVID pneumonia


VAERS ID: 1714934 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-04
Onset:2021-08-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Anti-platelet factor 4 antibody negative, Arteriosclerosis, Autopsy, Blood chloride increased, Blood creatinine increased, Blood glucose decreased, Blood potassium increased, Blood sodium normal, Blood urea increased, Cardiomegaly, Death, Dyspnoea, Malaise, Multipathogen PCR test, Pulmonary artery occlusion, Respiratory viral panel, Toxicologic test abnormal, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-09
   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: desonide fluocinolone ketoconazole albuterol budesonide fluticasone levothyroxine metformin sildenafil hydrocholorothiazid alprazolam
Current Illness:
Preexisting Conditions: hypothyroidism hypertension obesity
Allergies: Iodinated intravascular contrast flunisolide orlistat
Diagnostic Lab Data: Autopsy performed on 8/13/2021: Small and medium pulmonary arteries occluded by blood clots. cardiomegaly and atherosclerotic cardiovascular disease Respiratory viral panel PCR (postmortem nasopharyngeal swab): Adenovirus Heparin-PF4 IgG antibodies (postmortem blood): negative. laboratory note that autopsy sample was not appropriate for testing. Postmortem toxicology: positive naloxone Postmortem vitreous: sodium = 142 mmol/L, potassium = 26.9 mmol/L, chloride = 111 mmol/L, urea nitrogen = 21 mg/dl, creatinine = 1.3 mg/dl, and glucose = 27.0 mg/dl.
CDC Split Type:

Write-up: Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021.


VAERS ID: 1714965 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-01-22
Onset:2021-02-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Completed suicide, Ear discomfort, Stress, Tinnitus
SMQs:, Suicide/self-injury (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-16
   Days after onset: 184
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: A few days after the first covid vaccine patient started to experience left ear fullness and slight tinnitus. This lasted for approximatley 2-3 weeks. He was told he may have fluid in his ears and was treated with OTC medications for allergies, reported by patient to myself. After his second vaccine he developed tinnitus in the left ear. He went see his physician and they were unsure what the corelation was but he was then treated for stress and placed on Wellburtrin. After this trail and the tinnitus not getting anybetter, he stopped taking his Wellburtrin and began seeing a serious of ENT/ Audiologist - all could not determine the cause of tinnitus (they rule out MRI/neck/HL etc.). After a month of seeing ENTs/ PT he reported to me for severe tinnitus. He was wearing a HA at this time and we used sound enrichment and counseling to help cope with the onset of tinnitus. However, even after working with him for 7 months, referring to specialist along the way, attending counseling, PT, TMJ, etc. He ended his life by suicide due to the tinnitus on 8/16/21.


VAERS ID: 1714994 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-03
Onset:2021-08-01
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Cough, Death, Dyspnoea, Fatigue, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-14
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes Chronic Renal disease Chronic liver disease Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, cough, shortness of breath, difficulty breathing, Chest pain, fatigue. Death: 8/14/2021


VAERS ID: 1715223 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-05
Onset:2021-08-26
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Endotracheal intubation, Malaise, Mechanical ventilation, Respiratory failure
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), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 19
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: Albuterol inhaler Arformoterol nebs Biotin Budesonide nebs Bupropion SR 150 mg Cholecalciferol 50,000 unit capsule Clonazepam 0.5 mg tabs Cyanocobalamin 100 mcg tabs Estradiol 1 mg tabs Eszopiclone 1 mg tabs Fluticasone nasal spray Fluticas
Current Illness: COPD and restless leg syndrome
Preexisting Conditions: Asthma COPD Depression Hypothyroidism GERD Hypertension Hypoxemia Restless leg Syndrome
Allergies: Fluconazole - not specified Morphine - not specified Sulfa - not specified
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was hospitalized with COVID-19 symptoms on 8/26/2021 with respiratory failure. Patient was subsequently intubated and mechanically ventilated for a total of 17 days before being make compassionate care by family on 9/14/2021.


VAERS ID: 1715254 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-08-22
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Atrial fibrillation, COVID-19, Computerised tomogram thorax abnormal, Cough, Culture, Death, Dyspnoea, Endotracheal intubation, Heart rate increased, Hypoglycaemia, Hypotension, Intensive care, Metabolic acidosis, Pneumonia, Pulmonary cavitation, Renal failure, Renal impairment, Respiratory acidosis, Respiratory failure, SARS-CoV-2 test positive, Septic shock, Staphylococcal bacteraemia, Staphylococcus test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (broad), Neuroleptic malignant 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) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), 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 (broad), Hypoglycaemia (narrow), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-24
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID: Detected (8/22/2021)
CDC Split Type:

Write-up: 45 yo female s/p Pfizer COVID vaccination: dose 1 on 3/5 and dose 2 on 3/26. Past medical history significant for anemia of chronic disease, anxiety, ESRD on PD, depression, T1DM, HTN, GERD, gastroparesis, s/p kidney + pancreas transplant. Presented at the time of admission on 8/22 with shortness of breath and cough. Hospital course described: Septic shock 2/2 MRSA bacteremia: In setting of immunosuppression (cyclosporine). Growth of staph aureus on 8/22 and 8/23 cultures. MecA positive. Treated with vancomycin, meropenem, caspofungin, tobramycin. Clindamycin added 8/24. Respiratory failure thought secondary to COVID ARDS with potential bacterial pneumonia superimposed. Initially satting to 96% on RA, with quick increase in oxygen requirement overnight 8/22-8/23. Intubated and transferred to the MICU. CT PE without PE, but with bilateral pneumonia and findings concerning for necrosis in LLL and some cavitation medially in the right lung, possibly abscess formation. Concerning for development of an aspiration PNE. Treated with Remdesivir and Dexamethasone. CRRT for volume removal. Severe metabolic and respiratory acidosis: Gap (lactate) and non-gap (renal dysfunction) contributions. Thought secondary to septic shock and renal failure in setting of missed dialysis and acute infection. Required concentrated bicarb drip. She was also hypoglycemic as low as 37 treated with Dextrose infusion. She developed atrial fibrillation with rapid ventricular response evening of 8/24 with HR increased to 180s. This was treated with amiodarone bolus + drip as well as fluid resuscitation. HR responded to interventions however she remained hypotensive requiring addition of phenylephrine to her pressors. She required phenylephrine, levophed, and vasopressin for much of the evening as well as albumin, LR, bicarb pushes, and increasing rates of dextrose infusion. Transitioned patient to comfort care evening of 8/24. Palliative extubation performed that evening and all life sustaining medications were withdrawn. Patient was pronounced dead 8/24 at 2339.


VAERS ID: 1715261 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-02
Onset:2021-09-04
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Immune thrombocytopenia, Lymphoma, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Malignant lymphomas (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 09/04/2021 PCR+ COVID-19 test at Hospital; 09/05/2021 Antigen+ COVID-19 test at MEDICAL CENTER
CDC Split Type:

Write-up: Breakthrough COVID-19 case, hospitalization 9/4/2021-9/5/2021; death 9/5/2021. COD from vital records: LYMPHOMA, IMMUNE THROMBOCYTOPENIC PURPURA, COVID 19. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: None listed. place of death: HOSPITAL-INPATIENT, MEDICAL CENTER; certified by: CERTIFYING PHYSICIAN; occ/ind: SETTER OPERATOR, INDUSTRIAL MANUFACTURING ."Did the patient die?" marked YES; "Is this a COVID-related death?" marked YES.


VAERS ID: 1715267 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-17
Onset:2021-09-03
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 12
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: Shortness of breath.


VAERS ID: 1715299 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-30
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cardiac arrest, Death, Dyspnoea, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   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: Larin Levothyroxine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Short of breath, weak, lost consciousness, eventually lead to cardiac arrest, death


VAERS ID: 1715352 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-16
Onset:2021-09-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Death, Facial paralysis, Glassy eyes, Respiration abnormal
SMQs:, Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-18
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 88mcg PO daily Senna 8.6mg 1-2 tablets PO daily Tylenol 650mg PO 3 times daily Haloperidol 1mg PO 3 times daily as needed for agitation/restlessness Lorazepam 0.5-1mg PO every 2 hours as needed for anxiety/agitation Morphine 2
Current Illness: abnormal vaginal bleeding difficulty breathing
Preexisting Conditions: senile degeneration of the brain down syndrome bed confinement status
Allergies: no known allergies
Diagnostic Lab Data: None at this time; being reported to Office of Medical Examiner
CDC Split Type:

Write-up: Patient was on hospice for senile degeneration of the brain. She had been having abnormal vaginal bleeding in the months leading up to her death, and in mid July, she had increased facial drooping. The vaccine was administered on 9/16 and on 9/18 at 0540, her sister/ primary caregiver called to report that she was breathing "differently" and her "eyes were glassy". She died at 2239 on 9/18. It is unclear if the vaccine is related to her death; however, we are reporting to VAERS per CDC guidance. She is also being reported to the Office of the Medical Examiner.


VAERS ID: 1715421 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-08-19
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 UN / UN

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

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

Write-up: Last three days of nursing notes and discharge summary submitted into system. Patient had not tested positive for COVID since 12/2020.


VAERS ID: 1715467 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-08-19
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 UN / UN

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

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

Write-up: Nursing notes and discharge summary submitted. Patient had not tested positive to COVID since 12/2020.


VAERS ID: 1715501 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-09-19
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchoscopy abnormal, C-reactive protein increased, COVID-19, Cardio-respiratory arrest, Catheter placement, Computerised tomogram thorax abnormal, Dialysis, Dyspnoea, Echocardiogram abnormal, Endotracheal intubation, Extubation, Fibrin D dimer increased, Haemofiltration, Haemoglobin decreased, Haemoptysis, Intensive care, Lung disorder, Lung infiltration, Lymphadenopathy, Neoplasm malignant, Oxygen saturation decreased, Pleural effusion, Pulmonary alveolar haemorrhage, Pulmonary mass, Pulmonary oedema, Pulmonary thrombosis, Pulse abnormal, Pulseless electrical activity, Renal impairment, Renal tubular necrosis, Rib fracture, Right ventricular systolic pressure increased, SARS-CoV-2 test positive, Tachypnoea, Transfusion, Troponin increased, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (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 (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Osteoporosis/osteopenia (broad), Renovascular disorders (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-19
   Days after onset: 0
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: This is a 76yo male with a PMHx significant for chronic diastolic heart failure, CKDIII, cirrhosis of the liver, hepatocellular carcinoma, and HTN admitted on 9/4/2021 with increasing shortness of breath. He was tested positive for COVID and received the monoclonal antibodies on 9/2. His shortness of breath continued to worsen. He was admitted to Hospital and was originally requiring 10L nasal cannula. His troponin was mildly elevated with a maximum of 0.21. He received ceftriaxone and azithromcyin. His d-dimer was elevated and he was started on enoxaparin BID because CTA could not be obtained to rule out PE because of his renal function. He was transferred here to the medical unit. Cardiology, Vascular surgery and Nephrology were consulted. ECHO was obtained and showed no right heart strain, normal EF and increased right systolic pressure. Vascular surgery advised no thrombolysis therapy and to continue treatment dose enoxaparin. Cardiology felt his troponin elevation was due to supply demand mismatch and not ischemia. He was kept on dexamethasone but increased to BID dosing, ceftriaxone and azithromycin. Due to a CRP $g4, he was started on baricitinib, renally dosed. In the early morning of 9/6 his Optiflow cannula came out while he was sleeping. The nurse found him saturating in the 50s and pulse was thready. Rapid response was called and then he went into PEA and vfib. ACLS protocol was followed and patient received 2 rounds of epinephrine. He was not defibrillated because he came out Vfib prior to shocking. ROSC was achieved in 9 minutes. He was intubated and moved to the ICU. He was following commands and opening his eyes after the incident. Pulmonary/CCM was consulted. His hemoglobin dropped to 6.3 so was transfused 1 unit. Heme + stool, so PPI BID ordered. Baricitinib discontinued due to worsening renal function. He was extubated on 9/8 to high-flow nasal cannula. Unfortunately, he did not do well overnight with tachypnea and was re-intubated. His kidney function continued to worsen due to ATN from his cardiac arrest. Trialysis catheter was placed, and dialysis was initiated 9/10. Patient with hemoptysis 9/13. He underwent bronchoscopy, which revealed proximal clot but no active bleeding, and no active bleeding or endobronchial lesions in either lung. Patient started on high-dose steroids for alveolar hemorrhage. Pathology shows atypical cells suggestive of malignancy. CT chest performed shows extensive bilateral infiltration verses edema with consolidative airspace disease in bilateral lung bases, large bilateral pleural effusions, large subcarinal lymph nodes, left 1-7 rib fractures with right 4-6th rib fractures. Repeat bronchoscopy performed 9/17, showing some evidence of nodularity. No biopsies done due to risk of bleeding, washings were performed. CRRT started 9/17. Patient was not showing sign of improvement. Family presented to bedside to discuss goals of care. They ultimately chose to proceed with withdrawal of care and transition to comfort measures.


VAERS ID: 1715534 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-16
Onset:2021-08-03
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-11
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease
Allergies:
Diagnostic Lab Data: 08/04/2021 PCR+ COVID-19 test
CDC Split Type:

Write-up: Breakthrough COVID-19 case with symptom onset 8/3/2021: Diarrhea ($g/=3 loose/looser stools in 24 hr period). died on 8/11/2021


VAERS ID: 1715538 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Unknown  
Location: Tennessee  
Vaccinated:2021-08-03
Onset:2021-08-20
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Bradycardia, COVID-19 pneumonia, Death, Dyspnoea, Fatigue, General physical health deterioration, Hospitalisation, Mechanical ventilation, Myocarditis, Oxygen saturation decreased, PO2 decreased, Productive cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-04
   Days after onset: 15
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: po2-46
CDC Split Type:

Write-up: Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago. Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021.


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