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

This is VAERS ID 1036675

Case Details

VAERS ID: 1036675 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine increased, Blood culture negative, Blood urea increased, Brain natriuretic peptide increased, Cerebral haemorrhage, Chest X-ray abnormal, Computerised tomogram head abnormal, Condition aggravated, Culture negative, Death, Diarrhoea, Dyspnoea, Endotracheal intubation, Immunoglobulin therapy, Lung opacity, Nausea, Oesophagogastroduodenoscopy, Oxygen saturation decreased, Paralysis, Procalcitonin increased, Pupillary disorder, Pupillary light reflex tests abnormal, Respiratory failure, SARS-CoV-2 test negative, Troponin increased, Ventricular drainage, Viral test negative, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Haemorrhagic central nervous system vascular conditions (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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Sepsis (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-02-15
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acyclovir (ZOVIRAX) 200 MG capsule Take 1 capsule by mouth 2 times daily. albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler Take 2 puffs by inhalation Every 4 hours as needed for Wheezing (shortness of br
Current Illness:
Preexisting Conditions: Bilateral Lung Transplant due to Advanced Lymphoangioleiomymatosis Immunosuppressed status (HCC) Antibody mediated rejection of lung transplant (HCC) Bronchiolitis obliterans syndrome, grade 0P (HCC) Major depressive disorder with single episode, in full remission (HCC) RLS (restless legs syndrome) Chronic insomnia Long term current use of systemic steroids OSA (obstructive sleep apnea) Iron deficiency anemia Bilateral sciatica Pure hypercholesterolemia Hoarseness of voice Memory change Laryngeal stridor Senile nuclear cataract, bilateral Myopia of both eyes Osteoporosis without current pathological fracture, unspecified osteoporosis type Dry eyes, bilateral
Allergies: Voriconazole, NSAIDs
Diagnostic Lab Data:
CDC Split Type:

Write-up: 61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90''s with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient''s white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM.

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