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

This is VAERS ID 1081416



Case Details

VAERS ID: 1081416 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-02-22
Onset:2021-02-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain herniation, Cerebral haemorrhage, Cerebral mass effect, Coma, Death, Endotracheal intubation, Hypertension, Respiratory failure, Subarachnoid haemorrhage, Subdural haematoma
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 90 mcg inhaler 2 puffs q6h prn SOB ASA 81 mg PO daily Excedrin Extra Strength 1 tab PO PRN Atenolol 100 mg PO daily Caltrate 600+D 1 tab PO daily Cetirizine 10 mg PO daily Cholecalciferol 2000 unit PO daily Dicyclomine 20 mg PO da
Current Illness: None
Preexisting Conditions: Known L MCA cerebral aneurysm HTN Hypothyroidism
Allergies: Benzocaine Codeine Penicillins Sulfa
Diagnostic Lab Data: INR-0.9 - 2/25/2021
CDC Split Type:

Write-up: Pt. presented to ED via EMS for emergent coma. EMS intubated patient in field due to respiratory failure. Pt. was severely hypertensive with nearly total loss of brainstem reflexes. Patient had known L MCA cerebral aneurysm with appointment to undergo intervention to address in the near future. NCCT reported massive multifocal brain hemorrhage, SAH, SDH, and parenchymal hemmorhage with midline shift and subfalcine herniation. Due to dismal/poor prognosis, family requested withdrawal of support approximately 4 hours after presentation and patient expired shortly thereafter.


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