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

Found 481 cases where Vaccine is COVID19 and Manufacturer is PFIZER/BIONTECH and Symptom is Aortic thrombosis or Arterial thrombosis or Arterial thrombosis limb or Atrial thrombosis or Axillary vein thrombosis or Basilar artery thrombosis or Brachiocephalic vein thrombosis or Carotid artery thrombosis or Cavernous sinus thrombosis or Cerebral artery thrombosis or Cerebral thrombosis or Cerebral venous sinus thrombosis or Cerebral venous thrombosis or Coronary artery thrombosis or Deep vein thrombosis or Hepatic vein thrombosis or Iliac artery thrombosis or Injection site thrombosis or Intracranial venous sinus thrombosis or Jugular vein thrombosis or Mesenteric vein thrombosis or Ophthalmic artery thrombosis or Ophthalmic vein thrombosis or Pelvic venous thrombosis or Peripheral artery thrombosis or Portal vein thrombosis or Postpartum venous thrombosis or Pulmonary artery thrombosis or Pulmonary thrombosis or Retinal artery thrombosis or Retinal vascular thrombosis or Retinal vein thrombosis or Spinal artery thrombosis or Splenic vein thrombosis or Subclavian vein thrombosis or Superior sagittal sinus thrombosis or Thrombosis or Thrombosis in device or Transverse sinus thrombosis or Truncus coeliacus thrombosis or Umbilical cord thrombosis or Vena cava thrombosis or Venous thrombosis or Venous thrombosis limb and Patient Died

Government Disclaimer on use of this data

Table

   
AgeCountPercent
12-17 Years10.21%
17-44 Years183.74%
44-65 Years5210.81%
65-75 Years5912.27%
75+ Years9118.92%
Unknown26054.05%
TOTAL481100%



Case Details

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VAERS ID: 934745 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-01-09
Onset:2021-01-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Heart rate increased, Musculoskeletal stiffness, Oxygen saturation decreased, Peripheral coldness, Presyncope, Pulse absent, Respiratory rate increased, Seizure like phenomena, Skin discolouration, Skin warm, Thrombosis, Unresponsive to stimuli
SMQs:, 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), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-01-12
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Exelon 13.3 mg daily, APAP 500 mg three times a day, Namenda 10 mg two times a day, Senna 8.6 mg two tablets daily, Mirilax 27 grams two times a day, 2 cal 4oz three times a day, Amlodipine 5 mg daily
Current Illness: NA
Preexisting Conditions: Alzheimers, dementia, hypertension,
Allergies: NKA
Diagnostic Lab Data: Family requested comfort cares. No tests provided.
CDC Split Type:

Write-up: Resident had seizure like activity followed by a vagel response with large bowel movement. Resident then began to show signs of blood clot to left lower extremity. No pedal pulse, area on leg warm to touch. Left lower leg now cold to touch, stiff, purple and white in color. No other signs of modeling, body warm to touch, no fever noted. Respirations and pulse increased with low oxygen levels. Resident not responding to stimuli.


VAERS ID: 1000670 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-19
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Death, Myocardial infarction, Pain in extremity, SARS-CoV-2 test negative, Stent placement, Thrombosis
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-26
   Days after onset: 25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Test Name: Covid-19; Test Result: Negative
CDC Split Type: USPFIZER INC2021094694

Write-up: she was hurting at her chest/ Chest pain; on her left arm hurt real bad that''s what the clot on her left arm; on her left arm hurt real bad that''s what the clot on her left arm; She passed away; heart attack; This is a spontaneous report from a contactable consumer. An 87-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 19Jan2021 at single dose for COVID-19 immunisation. Medical history included diabetes mellitus, for which she was taking a pill like an hour before she would take her meal. On Monday (Jan2021) the patient experienced was hurting at her chest/ chest pain, her left arm hurt real bad as she had a blockage in her left arm/clot on her left arm, and they wanted to put in a stent and after the surgery it went well and she all go home in two days. The patient was hospitalized in Jan2021 due to the events. She had a heart attack and that the chamber between the dividers had a hole in it and her heart tissue was too thin so much thin she couldn''t repair it. The patient passed away on 26Jan2021. The patient was tested negative for COVID-19 on unknown date. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: She passed away


VAERS ID: 1012703 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-01-07
Onset:2021-01-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood calcium normal, Blood chloride increased, Blood creatinine increased, Blood glucose increased, Blood potassium normal, Blood sodium normal, Blood urea increased, COVID-19, Carbon dioxide normal, Confusional state, Cough, Differential white blood cell count normal, Ear haemorrhage, Fibrin D dimer increased, Full blood count, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin normal, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Metabolic function test, Nucleated red cells, Platelet count normal, Rales, Red blood cell count decreased, Red cell distribution width normal, SARS-CoV-2 test positive, Thrombosis, Vomiting, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin Tablet 81 MG clonazePAM Tablet 0.5 MG Colace Capsule 100 MG DULoxetine HCL Furosemide Tablet 20 MG Norvasc Tablet 10 MG Potassium Chloride ER CapsulE QUEtiapine Fumarate Tablet Galantamine Hydrobromide Tablet
Current Illness: Intermittent delusional periods-followed by Generations Mental Health.1/6 Increased BLE edema, BP trending up. Acute visit with APRN, N.O. started Lasix & KCL. CBC and BMP ordered for 1/8 with elevation in BMP/Creatinine. Lasix and KCL placed on hold. On palliative services presently.
Preexisting Conditions: Alzheimer?s Disease/Depression; HTN; CAD, CKD, AAA w/o Rupture, no surgical intervention per ADPOA, Dyslipidemia, GERD.
Allergies: HEPARIN LATEX BLEACHED SHEETS
Diagnostic Lab Data: 1/14-Covid Antigen test positive 1/14-11:49 am D-DIMER-32.33 WBC 8.71 RBC 4.55 HGB 12.9 HCT 41.4 MCV 91.0 MCH 28.4 MCHC 31.2 RDW-CV 12.6 MPV 10.1 Platelet Count 225 NRBC Automated 0.0 RDW-SD 41.7 Glucose 125 BUN 29 Creatinine 2.34 Calcium 9.4 Sodium 140 Potassium 4.2 Chloride 107 CO2 24 BUN/Creatinine Ratio 12.39 GFR 27
CDC Split Type:

Write-up: 1/14/2021-0545, blood noted left and right ear. 0715, vomited x 1. Covid Antigen positive. Acute MD visit-basilar crackles right and coughing. Increased confusion.


VAERS ID: 1017129 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Nevada  
Vaccinated:2020-12-17
Onset:2020-12-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Autopsy, Coronary artery thrombosis, Sudden cardiac death
SMQs:, Torsade de pointes/QT prolongation (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2020-12-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, aspirin.
Current Illness:
Preexisting Conditions: Hypertension. Diet & exercise-controlled diabetes. History of DVT 4 yrs prior to event. After completing a course of Xarelto has been on aspirin ever since.
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sudden cardiac death. Autopsy report: right coronary artery thrombosis.


VAERS ID: 1026980 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-22
Onset:2021-01-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Computerised tomogram thorax abnormal, Death, Nausea, Pulmonary embolism, Thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   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: METFORMIN, PIOGLITAZONE, NORTRIPTYLINE, TERAZOSIN, RISPERDONE, VIT D 3, DEPO-TESTOSTERONE, LOSARTAN, FLUTICASONE, NTG SL, CRESTOR, PROSCAR, ZOLOFT, MONTELUKAST, HYDROXYZINE, CARAFATE, OMEPRAZOLE, REGLAN, CENTRUM SILVER.
Current Illness: NONE
Preexisting Conditions: DIABETES, MOOD DISORDER, ELEV CHOL, CAD, HTN, BPH, DIABETIC NEUROPATHY, ENVIROMENTAL ALLERGIES, LOW VIT D, HYPOGONADISM, GERD
Allergies: NKDA
Diagnostic Lab Data: CT CHEST , CT ABDOMEN PELVIS, (01/23/2021) AUTOPSY 02/03/21??
CDC Split Type:

Write-up: Patient reported to Emergency room on 01/23/2021 with complaint of nausea. According to ER record patient reported he received a COVID 19 vaccine Pfizer the day before. Work up in the ER (CT ABD PELVIS) reveal a clotted of SMA. CT CHEST REVEALED BILATERAL PULMONARY EMBOLUS. THE PATIENT WAS TRANSFERRED TO THE STATE HOSPITAL. HE WAS SCHEDULED FOR EMERGENT VASCULAR SURGERY WHICH WAS CANCELLED AS THE PATIENT DIED SHORTLY AFTER HIS ARRIVAL.


VAERS ID: 1033682 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-04
Onset:2021-02-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Arterial disorder, Contusion, Death, Dysphagia, Haematoma, Haemorrhage, Limb mass, Oedema peripheral, Peripheral swelling, Skin discolouration, Suture insertion, Thrombosis, Vein disorder
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-12
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol tartrate 25 mg, 81 mg aspirin, 10 mg lisinopril, 2 mg glimepride, 20 mg furosemide (lasix)
Current Illness: polycythemia vera, dementia, type 2 diabetes mellitus, HTN
Preexisting Conditions: Type II DM
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: L hand edema, hematoma which burst and caused bleeding sending pt to the ER for pressure dressing and 2 stitches. L hand and arm progressively got more edematous and bruised looking (severely black/blue/purple) and the hand continued to bleed and swell on 2/6/21. Severe arterial and venous issues and apparent blood clots. On 2/7/21 there were also lumps noted on left inner thigh. Pt. stopped eating or drinking on 2/8/21 and expired on 2/12/21.


VAERS ID: 1035850 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-04
Onset:2021-02-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 UN / IM

Administered by: Work       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Echocardiogram, Laboratory test, Magnetic resonance imaging, Neurological symptom, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-13
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair 250-50mcg Allegra-D 24 hour 180-240mg Amlodipine 2.5mg Buspirone 10mg Carvedilol 12.5mg Montelukast 10mg Prednisone 20mg Albuterol Zoloft 100mg Spiriva Nasacort AQ
Current Illness: Sinus Infection being treated with steroids and antibiotics
Preexisting Conditions: Asthma Allergies Chronic Sinus infections Depression History of heart attack
Allergies: Aspirin Erythromycin
Diagnostic Lab Data: Multiple CT scans, MRI''s, echo''s, labs
CDC Split Type:

Write-up: Patient woke up on the morning of 2/6 with symptoms of a stroke. Rushed to hospital where clot found in brain. Recovered from initial stroke but then had another major stroke on 2/8 and never recovered.


VAERS ID: 1059421 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-02-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Brain injury, Cerebrovascular accident, Death, Hypoaesthesia, Magnetic resonance imaging abnormal, Magnetic resonance imaging brain abnormal, Malaise, Surgery, Thrombectomy, Thrombosis
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-26
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not Known
Current Illness: None
Preexisting Conditions: Arthritis - Macular Degeneration
Allergies: None Known
Diagnostic Lab Data: Clot removal surgery was conducted on March 19th, 2021. Subsequent MRI revealed stroke damage on both left and right side of the brain.
CDC Split Type:

Write-up: After the second vaccine dose she reported not feeling well with unspecified symptoms for a few days. On February 18th, 2021 she visited her doctor with numbness in her hand. They thought it may be carpal tunnel and sent her home. The morning or March 18th , 2021 she had a severe stroke and was transferred to Hospital and then to other hospital. She was in the hospital until Tuesday March 23rd when she was transferred back to her home for hospice care. She died on March 26th, 2021.


VAERS ID: 1065435 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-19
Onset:2021-01-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder, Fatigue, Nausea, Thrombosis
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HEPARIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart disorder; Pacemaker insertion (cardiac)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021206257

Write-up: blood clot; death cause: Heart Problems; tired; nauseous; This is a spontaneous report from a contactable consumer. An 81-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Lot number EL3248), via an unspecified route of administration at single dose in the left arm on 19Jan2021 14:00 for covid-19 immunisation. Medical history included heart problems, pacemaker. Concomitant medication included heparin. The patient experienced death cause: heart problems on 20Jan2021, blood clot on an unspecified date with outcome of unknown that required hospitalization, tired on 19Jan2021 with outcome of unknown, nauseous on 19Jan2021 with outcome of unknown. The patient was hospitalized for blood clot from 16Jan2021 to 18Jan2021. The patient died on 20Jan2021. An autopsy was not performed. The events were described as follows: The patient was tired and nauseous about 3 hours after her vaccine. She had been in the hospital 16Jan2021 to 18Jan2021 for a blood clot. The patient died at her home on 20Jan2021 between 4 and 7 pm. No treatment required. The vaccine was administered at Hospital Facility. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: death cause: Heart Problems


VAERS ID: 1068762 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-11
Onset:2021-03-02
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM

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: 2021-03-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: DEATH Narrative: patient''s wife reported he had gone in an outside hospital, had held his brilinta as advised anticipating shoulder surgery "and he threw a big clot and died."


VAERS ID: 1068886 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-26
Onset:2021-01-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Arrhythmia, Chest discomfort, Chills, Death, Deep vein thrombosis, Dyspnoea, Intensive care, Pain, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-26
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: DEATH Narrative: Pt he reports he developed chills SOB body aches the same night as receiving the COVID vaccine on 1.26.2021-pt is currently reporting CheSt tightness and SOB Admitted to hosp: ICU with Bilateral Pulmonary Emboli, LLE DVT, NSTEMI, Arrhythmia.


VAERS ID: 1085254 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-01
Onset:2021-03-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Aspiration, Cardiac arrest, Death, Feeding disorder, Gastric aspiration procedure, Gastric lavage, Gastrointestinal necrosis, Insomnia, Mechanical ventilation, Pulmonary necrosis, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-05
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: furosemide metaprolol eliquis lisprinopril pravastatin doxazosin glimeperide omperozole diltiazem potadsium
Current Illness:
Preexisting Conditions: stroke in 2016
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe abdominal pain unable to eat or sleep for 36 hours. He went by ambulance to the Hospital emergency room. They tried to pump his stomach but he aspirated and and went into cardiac arrest. He was revived but never regained consciousness. (The ICU Dr said that he had blood clots in his abdomen from a recent stroke. We were unaware of him having a stroke other than in 2026. The same Dr. said that he had necrosis in his lungs from aspirating. The necrosis was from his bowel dying) He was put on a ventilator and given drugs to increase his heart rate. On 3-5-21 the heart drugs were reduced and he died. I was with him when he recieved the vaccination and he was healthy, just old. I think that the shot killed him.


VAERS ID: 1090240 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-10
Onset:2021-02-01
Submitted: 0000-00-00
Entered: 2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature, COVID-19 pneumonia, Cardiac arrest, Chest X-ray, Decreased appetite, Dehydration, Heart rate, Hypotension, Hypoxia, Investigation, Oxygen saturation, Physical examination, Pulmonary embolism, Pyrexia, Renal failure, Respiratory arrest, Respiratory failure, SARS-CoV-2 test, Thrombosis, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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 (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-04
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cataract extraction; Rotator cuff repair
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:normal, it hardly ever went above 120; Test Date: 2021; Test Name: blood pressure; Result Unstructured Data: Test Result:low; Test Date: 20210212; Test Name: temperature; Result Unstructured Data: Test Result:102; Test Date: 20210213; Test Name: temperature; Result Unstructured Data: Test Result:102; Test Date: 20210214; Test Name: temperature; Result Unstructured Data: Test Result:99.8; Test Date: 2021; Test Name: Chest x-ray; Result Unstructured Data: Test Result:mild pneumonia; Test Date: 2021; Test Name: heart rate; Result Unstructured Data: Test Result:135; Comments: highest heart rate was after intubation; Test Date: 2021; Test Name: fluid challenge; Result Unstructured Data: Test Result:his labs were a little better than the labs kept c; Comments: his labs were a little better than the labs kept creeping up until the doctor inserted a shiley catheter for dialysis; Test Date: 20210215; Test Name: numbers; Result Unstructured Data: Test Result:patient''s numbers were getting better after the; Comments: fluid challenge and then his numbers kept creeping up after that.; Test Date: 2021; Test Name: rhythm strip; Result Unstructured Data: Test Result:rhythm strip which showed a flat line and then she; Comments: rhythm strip which showed a flat line and then she noticed ventricular tachycardia, then a flat line; Test Date: 2021; Test Name: oxygen saturation; Result Unstructured Data: Test Result:The patient started de-saturating; Test Date: 202012; Test Name: physical; Result Unstructured Data: Test Result:A1C was 5.7; Comments: The patient had no cholesterol or hypertension; Test Date: 20210214; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC2021248929

Write-up: Cardiac arrest; Pulmonary embolus; Renal failure; Fever; Dehydration; Not eating or drinking; COVID-19 confirmed by positive COVID-19 test / COVID pneumonia; blood clot; blood pressure was low; Respiratory arrest; Respiratory failure; Hypoxemia; ventricular tachycardia; This is a spontaneous report from a contactable nurse reporting on behalf of the husband. A 71-year-old male patient received the first single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EL9264) on 10Feb2021 at about 19:00 (at the age of 71 years), in left deltoid, for COVID-19 immunisation. No other vaccines were given on the same day or within 4 weeks. The patient declined flu vaccine and pneumococcal vaccine (PNEUMOVAX), he had never had another vaccine except maybe his childhood vaccines. Medical history included rotator cuff surgery and cataract removed in 2020. The patient exercised regularly, he was healthy, he walked for miles and didn''t eat any non-sense, he did not eat out, he did not smoke. The patient''s mother was 100 years old and fully competent. The patient had two sisters older than him, the oldest one had hypertension the second sister did not have anything that they were aware of. The patient''s father lived until he was 98 years old. The patient concomitant medications were none. The patient was told to take vitamin D 50,000 units but didn''t even take them (he still had 9 of them in the bottle and they gave him 13). The patient experienced fever on 11Feb2021, renal failure on 14Feb2021, pulmonary embolus on 28Feb2021, cardiac arrest on 04Mar2021, dehydration and not eating or drinking on an unspecified date in Feb2021. These events required ER visit and were reported as serious as involved hospitalization from 14Feb2021 to 04Mar2021 and as fatal events. The patient died on 04Mar2021. Clinical course of the events included the following information. The patient received the first vaccine on 10Feb2021, the next day he developed a fever. The reporter spoke with the patient''s doctor who told to give the patient paracetamol (TYLENOL) thinking the fever was from the vaccine. On 12Feb2021 and 13Feb2021, the patient''s temperature was 102. Then the doctor advised to take the patient to the hospital. The patient''s temperature was still 102, he was in renal failure, and they had to dialyze him. The patient was otherwise healthy, the patient''s last physical was in Dec2020 and the only thing it showed was that his A1C was 5.7. The patient had no cholesterol or hypertension. The doctor advised the patient to decrease sugar and carbs because the holidays were coming up. The patient''s follow up was scheduled on Mar2021. The reporter felt that the vaccine has something to do with the patient renal failure. The reporter spoke with the doctors at the hospital who didn''t want to commit to anything. The reporter believed this was an adverse event. The caller mentioned that she had her vaccine before and she was fine. The patient was admitted on 14Feb2021 and by Wednesday he was not eating or drinking, he was dehydrated. The patient''s admitting diagnoses was elevated temperature and ruling out COVID. The patient tested positive for Covid on 14Feb2021 (COVID-19 PCR test). The patient''s temperature was 99.8 and then kept creeping up, on Saturday it was 102. The caller gave the patient Tylenol cold and flu (lot T0CL001021, expiry date Oct2021) took the edge off but in three hours the temperature was back up again. The patient never complained of pain and didn''t want to take Tylenol. On 15Feb2021 the patient''s numbers were getting better after the fluid challenge and then his numbers kept creeping up after that. The patient had the fever a week until they had it under control. The fever went away, it was gone for like 5 days, then it spiked again. The patient was started on piperacillin/tazobactam (ZOSYN) for like 3 or 5 days and the fever went away but then it kept getting worse. On 28Feb2021, the medical personnel thought the patient had a pulmonary emboli but because of the renal failure, they couldn''t do a computerized tomography on the patient. The doctors mentioned that the patient was in renal failure and they thought they heparinized the patient and he had a blood clot who led to pulmonary embolus, cardiac arrest, and death. The patient was diagnosed with a pulmonary emboli on 28Feb2021. The patient started de-saturating and the doctors intubated and sedated him that whole time until this. Dialysis was started on 01Mar2021 and the patient received it every day except 04Mar2021. The patient''s blood pressure was normal, it hardly ever went above 120. The patient was on the medical floor from 22Feb2021 to 04Mar2021. When the patient was on the medical surgical floor, he was on high flow 5 liters. After the patient started desaturating, he went to the intensive care unit and was put on a non-rebreather on 45%. The patient''s highest heart rate was after intubation was 135, but the patient''s blood pressure was low so they started him on some vasopressors. They did the fluid challenge on the patient and his labs were a little better than the labs kept creeping up until the doctor inserted a shiley catheter for dialysis. Respiratory: Respiratory arrest and then cardiac arrest. Respiratory failure, they intubated the patient. The reporter assumed dyspnea because the patient was intubated. Tachypnea was when the patient was in the intensive care unit already intubated. Hypoxemia, they intubated the patient so the caller guessed it was for the oxygen saturation drop. Covid pneumonia: yes. Chest x-ray showed mild pneumonia. The caller requested a follow up x-ray and the doctors said they were going to do another one but the caller is unsure if they did or when. The patient received additional therapies for COVID-19: remdesivir. Other radiological investigations: unable because of the patient''s kidney function. They were looking at the D dimer and BMP to come up with the embolus since the patient couldn''t have the scan. ARDS: no. Cardiovascular: The patient had a heart attack on 04Mar2021. The reporter thought it was from the pulmonary embolus which led to cardiac arrest. Arrhythmia: the caller guessed so, the patient was being worked on for 10 minutes before the caller got there. The caller saw a rhythm strip which showed a flat line and then she noticed ventricular tachycardia, then a flat line. The patient did not have SARS-CoV2 antibodies at diagnosis. Gastrointestinal/Hepatic, neurological, hematological, dermatological: none. Vascular: pulmonary embolus: yes, deep vein thrombosis, limb ischemia, vasculitis: no. Renal: renal failure: yes, acute kidney injury: no. The patient was scheduled for his second vaccine dose on 03Mar2021 at 04:15 but did not receive it. Time of death was 4:15 in the afternoon on 04Mar2021. The reporter considered renal failure, fever, dehydration, not eating or drinking, cardiac arrest and pulmonary embolus as fatal and related to the suspect vaccine. The outcome of the other events was unknown. Cause of death was unknown. No autopsy was performed.; Sender''s Comments: Based on current information available, the company considered there is a possibility that all reported events are consequence of COVID-19 pneumonia on the basis of advanced age. The positive COVID-19 test occurred 4 days after the first injection of suspect vaccine BNT162B2. No complete effect can be achieved for short time interval. The COVID-19 is more likely pre-existing colonization or intercurrent condition, unrelated to suspect vaccine 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 RAs, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: Renal failure; Fever; Dehydration; Not eating or drinking; Cardiac arrest; Pulmonary embolus


VAERS ID: 1092477 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-17
Onset:2021-03-07
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Pericardial effusion, Portal vein thrombosis
SMQs:, Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), 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: 2021-03-08
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pacemaker
Allergies: None
Diagnostic Lab Data: CAT scans - 3/8/2021
CDC Split Type:

Write-up: Pericardial effusion; multiple blood clots in portal vein.


VAERS ID: 1105772 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-11
Onset:2021-02-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure decreased, Constipation, Death, Gait disturbance, Gait inability, Thrombosis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-19
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D, Docusate Softgel, Amlodipine, Trazodone, Multivitamin, Clonidine, Sea, Lisinopril, Citalopram, Acetamin, Pantoprazole, Santyl Ointment, Calcium Antacid Chew, Olanzapine
Current Illness: Dementia with associated mental illness, and high blood pressure. Bed sore on foot.
Preexisting Conditions: Dementia with associated mental illness, high blood pressure, recovery from broken hip
Allergies: None known
Diagnostic Lab Data: I do not have all this information at hand. Hospital would have it all.
CDC Split Type:

Write-up: My mother died on February 19, 2021. She had her 2nd dose vaccine on 2/11, on 2/12 it was noted that she was not able to walk, on 2/13 she was walking at 30%, on 2/14 she was walking with difficulty, on Monday 2/15 she was throwing up violently and her blood pressure dropped, so she was sent to Clinic. My sister was told she was just constipated and she had A Fib (never reported before to us). My sister was then told on 2/16 early a.m. that she had a blood clot that destroyed her colon. Due to age surgery would likely not be successful. She then died on the Friday. We are reporting in the event that the Pfizer vaccine was somehow a contributing factor to the A fib or to the Clot. She has no history of A fib or clotting prior to this incident. She was 93, and did have dementia, but was able to eat normal foods prior to this. What was unusual was the challenge in walking the day after the shot. Other than that no difference was observed until the day she was admitted to the hospital emergency room. She was a resident at Assisted Living, Memory Care, and that is where she received the vaccine. The mailing address I provided is her mailing address prior to death.


VAERS ID: 1349979 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-03
Onset:2021-03-04
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Deep vein thrombosis, Haemorrhagic transformation stroke, Ischaemic stroke
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, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: Deceased Narrative: Patient was a 82 yo male with multiple co-morbidities consisting of AF (on warfarin), prio PE, HFrEF, CAD, HTN, mixed CSA/OSA, hypothyroidism, COPD and GERD. Patient was admitted to facility on 7/12/20 after he was found down in his home for 3 days, dx with right MCA ischemic stroke with hemorrhagic conversion. Etiology of CVA was presumed to be secondary to AF/warfarin failure. No treatment with tPA or thrombectomy was initiated as he was outside the window for intervention. Patient was also found to have bilateral DVTs. Patient was then admitted to facility 08/14/20 for end of life care.


VAERS ID: 1113713 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-01
Onset:2021-02-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebral thrombosis, Constipation, Contusion, Death, Endotracheal intubation, Flatulence, Gastrointestinal oedema, General physical health deterioration, Haemoptysis, Intensive care, Intestinal haemorrhage, Intracardiac thrombus, Malaise, Peripheral swelling, Pulmonary haemorrhage, Pulmonary thrombosis
SMQs:, Cardiac failure (broad), Angioedema (broad), 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), Embolic and thrombotic events, venous (narrow), Gastrointestinal haemorrhage (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-17
   Days after onset: 43
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data: I don''t know what lab work they did. My brother who lives with her works in their lab at the location and may know. My other who is a pharmacist works in the hospital''s location and was her proxy. The proxy refused to consider that her condition was due to the vaccine stating that February was too long ago for the two to be related. He was in denial. I feel the hospital staff was in denial. They wouldn''t consider that the vaccine caused blood clots in my mom. My mother died.
CDC Split Type:

Write-up: My mother called me when she was going to get her second vaccination. She was alive and well and living independently at her home. She could walk, talk, make her own food, wash and dry her own clothes and take her own baths. After taking the second vaccination she went down hill. She became sicker and sicker and eventually she started coughing up blood. She decided to go to the hospital, another Hospital of facility. I don''t know what the treatment was at that hospital but she was soon transferred to facility and that is where I was notified she was in the hospital and visited her there. After arriving they intubated her and said she had blood clots in her brain and heart. When I saw her after she transferred from Hospital to the Hospital I noticed one arm was swollen. Her legs were as they have been for the last 20 years and looked okay to me--no discoloration other than her regular discoloring at one right ankle and the same old same old slight swelling in the left ankle. The doctors and nurses were putting the blame on her legs but you could tell things were happening else where. But as she got worse and worse at the hospital her right arm become more and more swollen with dark bruises appearing--the hospital staff took pictures. The left arm continued to swell and did not look normal at all. She apparently had bleeding in her left lung from a blood clot. She had three areas of her brain that add clots and some bleeding. She was constipated and gaseous when they cleaned her. They didn''t treat her constipation which made being intubated worse because I feel that caused her intestines to swell, thus she also had bleeding in her intestines. My mother died on March 17, 2021 at hospital in ICU. I was told they could not treat the blood clots because of the bleeding in her lung, intestines and brain.


VAERS ID: 1140696 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-02
Onset:2021-02-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Acute myeloid leukaemia, Band neutrophil count, Band neutrophil count increased, Blast cell count increased, Blast cells, Cerebral haemorrhage, Disseminated intravascular coagulation, Haemorrhagic stroke, Ischaemic stroke, Leukaemia, Metamyelocyte count, Metamyelocyte count increased, Monocyte count, Monocyte count increased, Myelocyte count, Myelocyte count increased, Neutrophil count, Neutrophil count decreased, Pain in extremity, Platelet count, Platelet count decreased, Red cell distribution width, Red cell distribution width increased, SARS-CoV-2 test, Thrombosis
SMQs:, Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Blood premalignant disorders (narrow), Thrombophlebitis (broad), Myelodysplastic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-02-23
   Days after onset: 19
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VITAMIN C [ASCORBIC ACID]; CALCIUM CITRATE + D3; GLUCOSAMINE; MAGNESIUM CITRATE; OMEGA 3 [DOCOSAHEXAENOIC ACID;EICOSAPENTAENOIC ACID;TOCOPHERYL ACETATE]; TURMERIC [CURCUMA LONGA]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer (Breast Cancer 8 Years ago. No Chemo just radiation); Radiation therapy
Allergies:
Diagnostic Lab Data: Test Date: 20210204; Test Name: Band Neutrophils; Result Unstructured Data: Test Result:High; Comments: Band Neutrophils H; Test Date: 20210204; Test Name: Other Cell Type Blast Like Cells; Result Unstructured Data: Test Result:High; Comments: Other Cell Type Blast Like Cells H; Test Date: 20210204; Test Name: Metamyelocytes; Result Unstructured Data: Test Result:High; Comments: Metamyelocytes H; Test Date: 20210204; Test Name: Monocytes; Result Unstructured Data: Test Result:High; Comments: Monocytes H; Test Date: 20210204; Test Name: Myelocytes; Result Unstructured Data: Test Result:High; Comments: Myelocytes H; Test Date: 20210204; Test Name: Absolute Neutrophils; Result Unstructured Data: Test Result:Low; Comments: Absolute Neutrophils L; Test Date: 20210204; Test Name: Neutrophils; Result Unstructured Data: Test Result:Low; Comments: Neutrophils L; Test Date: 20210204; Test Name: Platelet Count; Result Unstructured Data: Test Result:Low; Comments: Platelet Count L, Platelet Vol; Test Date: 20210204; Test Name: Red cell distribution width; Result Unstructured Data: Test Result:Dev. H; Comments: RDW Stand. Dev. H; Test Date: 20210204; Test Name: Red cell distribution width; Result Unstructured Data: Test Result:Var H; Comments: RDW Coeff Var H; Test Date: 20210219; Test Name: Covid-19; Test Result: Negative
CDC Split Type: USPFIZER INC2021308114

Write-up: Multifocal Intracerebral Hemorrhage; Disseminated Intravascular Coagulopathy; strokes, Ischemic and Hemorrhagic; strokes, Ischemic and Hemorrhagic; AML; Leukemia; Blood clot diagnosis; Sore lower leg; RDW Stand. Dev. H/RDW Coeff Var H; Platelet Count L, Platelet Vol L; Neutrophils L; Band Neutrophils H; Monocytes H; Metamyelocytes H; Myelocytes H; Absolute Neutrophils L; Other Cell Type Blast Like Cells H; This is a spontaneous report from a contactable consumer. A 70-year-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE) lot number: EL9261, via an unspecified route of administration, administered in Arm Right on 02Feb2021 08:30 (Batch/Lot Number: EL9261) as SINGLE DOSE for covid-19 immunisation. Medical history included breast cancer (8 years ago no chemo just radiation). Historical vaccine included first dose of BNT162B2 (lot number: EL0140) on 11Jan2021 for Covid-19 immunization. Concomitant medication included vitamin c [ascorbic acid] (VITAMIN C [ASCORBIC ACID]), calcium citrate, colecalciferol (CALCIUM CITRATE + D3), glucosamine, magnesium citrate, docosahexaenoic acid, eicosapentaenoic acid, tocopheryl acetate (OMEGA 3 [DOCOSAHEXAENOIC ACID;EICOSAPENTAENOIC ACID;TOCOPHERYL ACETATE]) and curcuma longa (TURMERIC [CURCUMA LONGA]). On 04Feb2021, the patient''s blood work result showed red cell distribution width (RDW) stand. dev. high; RDW coeff var high, platelet count low, platelet vol low; neutrophils low; band neutrophils high; monocytes high; metamyelocytes high; myelocytes high; absolute neutrophils low; other cell type blast like cells high. On 15Feb2021, the patient experienced sore lower leg. On 16Feb2021, the patient was diagnosed with blood clot. On 19Feb2021, the patient was diagnosed with leukemia. On 20Feb2021, the patient was diagnosed with acute myeloid leukemia (AML). On 21Feb2021, the patient had tow types of stroke, ischemic and hemorrhagic, the patient was intubated. On 23Feb2021, the patient was extubated and died due to multifocal intracerebral hemorrhage, disseminated intravascular coagulopathy, acute myeloid leukemia with blast crisis. The patient received chemotherapy and leukapheresis as treatment. The patient died on 23Feb2021. An autopsy was not performed.; Reported Cause(s) of Death: Disseminated Intravascular Coagulopathy; Acute Myeloid Leukemia With Blast Crisis; Multifocal Intracerebral Hemorrhage


VAERS ID: 1146761 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-02-06
Onset:2021-03-04
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiogenic shock, Coronary artery occlusion, Myocardial infarction, Thrombosis
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-06
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SPIRONOLACTONE; VALSARTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal (treated successfully with medication for about 10 years); Breast cancer female
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021312390

Write-up: "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; Cardiogenic shock; Anterior myocardial infarction; This is a spontaneous report from a contactable consumer. An 81-years-old female patient received BNT162B2, dose 2 via an unspecified route of administration, administered in left arm on 06Feb2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Medical history included very sensitive to medication effects (usually takes only 1/2 dose with strong efficacy to avoid side effects). Breast cancer survivor (2014 onset, 2019 declared permanent remission) and mild blood pressure treated successfully with medication for about 10 years. Concomitant medications included spironolactone and valsartan, both taken for blood pressure. The patient previously received first dose of BNT162B2 on 16Jan2021 in left arm for COVID-19 immunization. The reporter''s mother died 3 weeks and 6 days after having received the second dose of the Pfizer covid vaccine. The cause of death was a "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; the event began about 11:45pm on 04Mar2021. The blockage was confirmed via cardiac cath procedure performed within 2 hours of the onset by Doctor, he removed the clot and placed a stent. However her heart was too damaged and could not recover. Doctor confirmed to us that she did not have excessive or evidence of any prior blockage and not excessive plaque. The blood clot likely came on and caused the cardiac event within roughly an hour, he explained. The patient had no prior symptoms and no comorbidities for blood clotting and was full of life and energy on 05Mar up to when she went to bed that night. She died 06Mar at 4:04 am at hospital. The strat date of the events was reported as 04Mar2021 at 11:45 PM. AE resulted in emergency room/department or urgent care, life threatening illness (immediate risk of death from the event). The patient died on 06Mar2021. An autopsy was not performed. The death cause: Triggered by the sudden 100% blockage of the LAD by a blood clot, the cause of death is listed as (A) Cardiogenic shock (B) Anterior myocardial infarction. Treatment was received for the events which included multiple resuscitations and angioplasty surgery. No covid prior vaccination, no covid tested post vaccination. The outcome of the events was fatal. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; "widow maker" type heart attack where the LAD artery suddenly became 100% blocked by a blood clot; "widow maker" type heart attack where the LAD artery


VAERS ID: 1151636 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-03
Onset:2021-02-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / UNK UN / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdomen scan, Asthenia, Bacterial infection, Bilevel positive airway pressure, Blood test abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Death, Dyspnoea, Electrocardiogram, Enterocolitis infectious, Feeling abnormal, Mechanical ventilation, Nausea, Oxygen saturation decreased, Pneumonitis, SARS-CoV-2 test positive, Thrombosis, Tremor, Vomiting, Walking aid user
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-14
   Days after onset: 30
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvastatin, Metoprolol, St Joesph aspirin
Current Illness:
Preexisting Conditions: CLL, CKD
Allergies: sulfa
Diagnostic Lab Data: Covid test - positive, chest xray - covid pneumonia, blood work - E Coli bacterial infection, EKG, chest xray - blood clots
CDC Split Type:

Write-up: My father received his first Pfizer vaccine on 02/03/21. On 2/12/21 I rushed him to the ER. He was vomiting uncontrollably and had shortness of breath. Once arrived at ER, they immediately put him on oxygen. Vomiting lasted several hours. They tested him for Covid and did a chest x-ray. Tested positive for Covid. Chest x-ray showed Covid pneumonia. Was admitted. Stayed in hospital for 5 days and was then released to nursing home for physical and occupational therapy. He was very weak and on days experienced what they called Covid fog. After 2 weeks of therapy, he was released on 03/06/21 to go back home to his apartment, with extended visiting nurse therapy. On 3/10/21, was the first visiting nurse appointment. At 12:00 an RN came to his apartment from Home Health Care. She checked his vitals. She said his blood pressure was good, lungs sounded good and oxygen level was 98. She said he was doing good and that she would not need to continue to come out and check on him weekly. She left. At 2:30 the same day, a Physical Therapist from Home Health Care came. She asked him lots of questions and adjusted my fathers'' walker for him. He showed her how he was doing using the walker. Walked approximately 15-20 feet in his apartment. She checked his vitals before she left. His oxygen level was now at 91. She had him take a few deep breathes until his oxygen level was up to 93. She left and said she would be back on Friday the 12th to begin the actual physical therapy then. Within 10 minutes after she left my father started shaking uncontrollably and was having difficulties breathing. I called 911. Paramedics arrived. My fathers'' oxygen level was all the way down to 74. They took him to the ER. When getting him out of ambulance he began vomiting. Vomiting lasted for hours just like when he went to the hospital back in February. They tried 3 different drugs to control the nausea. They did EKG, chest and abdomen scans. Was found that he had multiple blood clots and inflammation in his lungs and a bacterial infection in his blood. After testing, bacteria was found to be E Coli. Treated him with heparin for clots and antibiotics for infection and had him on oxygen in nose. Every day thereafter, he felt worse. They switched him to a high flow oxygen mask to keep his oxygen levels up. By Saturday night (early morning Sunday) on 03/14, they had taken the high flow oxygen mask off and hooked him up to a BiPap oxygen machine because his oxygen levels were dropping too low. We were then told by the lung doctor, that the damage to his lungs was extreme and that the next step would be to put him on a ventilator and feeding tube. My father did not want this per his will and his discussion with Dr earlier in the week. Dr indicated that he would not get better just being on the BiPap machine and we then chose to have them take him off of the machine because he did not want to go on life support. My father passed away on Sunday, March 14th around 6:30pm.


VAERS ID: 1152698 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-19
Onset:2021-02-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Haemorrhage intracranial, Venous thrombosis
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), Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-07
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvasatin,trazadone,nexium, allopurinol
Current Illness: gout,hyperlipedemia
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: Head CT with venous thrombosis and intracranial bleed
CDC Split Type:

Write-up: stroke -venous thrombosis


VAERS ID: 1160713 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-07
Onset:2021-03-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time prolonged, Acute kidney injury, Angiogram abnormal, Aspiration, Atelectasis, Blood culture, Blood lactic acid increased, Brain injury, Brain natriuretic peptide increased, Breath sounds absent, Bronchoscopy abnormal, Cardiac arrest, Chest X-ray normal, Chest wall haematoma, Cholelithiasis, Coagulopathy, Computerised tomogram abdomen, Computerised tomogram abnormal, Computerised tomogram head normal, Computerised tomogram thorax, Death, Electroencephalogram abnormal, Haemoglobin decreased, Haemorrhage, Haemothorax, Hepatic enzyme increased, Hypotension, Intensive care, International normalised ratio increased, Lung infiltration, Lung opacity, Magnetic resonance imaging head abnormal, Mediastinal haematoma, Mydriasis, Nitrite urine present, Protein urine present, Pulmonary hypertension, Pulmonary oedema, Pulse absent, Pulseless electrical activity, Pupil fixed, Resuscitation, Rib fracture, Seizure, Status epilepticus, Sternal fracture, Thrombosis, Transfusion, Troponin increased, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Lactic acidosis (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-20
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA, aspirin EC, atorvastatin, dabigatran, furosemide, gabapentin, isosorbide mononitrate CR, losartan, metoprolol succinate-XL, potassium chloride SA
Current Illness: NA
Preexisting Conditions: Chronic kidney disease, Cardiomyopathy, UTI, hemothorax, chronic atrial fibrillation
Allergies: contrast dye, warfarin
Diagnostic Lab Data:
CDC Split Type:

Write-up: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cardiac arrest (HCC) [I46.9] HOSPITAL COURSE: Patient is a 74 year old female who receives care through healthcare clinic and second healthcare clinic with past medical history of HTN, CKD, cardiomyopathy/congestive heart failure, atrial fibrillation on Pradaxa who presented to the ED 3/16 after suffering an out of hospital cardiac arrest at her dentist''s office. Per report, patient had SBP in the 80s on arrival but was asymptomatic. Prior to start of any procedure (no reports of being given sedative medications), she became unresponsive. CPR was initiated and was found to be in asystole. She received 3 rounds of CPR with ROSC. CT head without acute abnormality. Chest XR showing mild vascular congestion and interstitial edema. Initial labs showing AKI, elevated liver enzymes, BNP $g29,000, troponin 39, lactic acid of 11, INR of 6.6, PTT 62, APTT 87. UA with protein, nitrite, moderate blood. Urine culture ordered. Blood cultures ordered. In ED, patient was hypotensive requiring addition of vasopressors. Targeted temperature management was started. Ceftriaxone and flagyl started for possible urinary tract infection and aspiration. Patient with profound coagulopathy, INR increasing to 12.0 on arrival to the ICU. Two units FFP and vitamin K were given. Patient with escalating pressor requirements at this time so CT t/a/p was ordered showing multiple bilateral rib fractures, nondisplaced sternal fracture with small anterior mediastinal retrosternal hematoma, small right sided hemothorax, right chest wall hematoma, patchy bilateral airspace disease consistent with atelectasis/infiltrate/aspiration, diffuse GGO consistent with interstitial edema, enlarged pulmonary arteries consistent with pulmonary hypertension, cholelithiasis. FDP elevated and 2 units of cryoprecipitate given 3/16. Hemoglobin decreased to 5.9 3/17 with INR of 5.4. Two additional units of FFP and additional dose of vitamin K ordered. Two units RBCs ordered. CTA thorax and abdomen 3/17 re-confirmed hemothorax and chest wall hematoma but no active bleeding noted. CT bilateral LE showed no evidence of hematoma. Trauma consulted who recommended chest tube placement. Overnight 3/16-3/17, patient also noted to have seizure activity on EEG and patient loaded with Keppra. Head CT 3/17 negative for hemorrhage or other acute processes. Patient remained in status epilepticus 3/17am and additional Keppra load was given and neurology consulted. Received Praxbind for continued bleeding/coagulopathy. 3/17pm went into PEA arrest with 10 minutes of CPR with ROSC. Bronchoscopy following ROSC noted evidence of bleeding from multiple areas, clots removed. MRI brain showing diffuse anoxic brain injury. Propofol stopped 3/19am. After goals of care discussion this morning, all first degree relatives (daughter and son) all in agreement to transition to comfort care measures. I received call from bedside RN that patient had passed away. On exam, no heart or breath sounds appreciated upon auscultation for 2 minutes. No spontaneous movement or chest rise noted. No pulse palpated for two minutes. Pupils fixed and dilated. No response to noxious stimuli. Time of death 1400 3/20/2021.


VAERS ID: 1163369 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-02-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       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: 2021-03-07
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clots


VAERS ID: 1183985 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2020-09-18
Onset:2020-09-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure fluctuation, Blood pressure measurement, Death, Dysphonia, Fatigue, Headache, Heart rate, Illness, Muscular weakness, Pneumonitis, Pulmonary oedema, Pulmonary thrombosis, Pulse abnormal, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   Days after onset: 135
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: PANTOPRAZOLE; ASPIRIN (E.C.); FUROSEMIDE; FIRDAPSE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Brain metastases; Gait disturbance; Lambert-Eaton myasthenic syndrome (Cannot walk without FIRDAPSE); Metastases to liver; Metastases to lymph nodes; Migraine (Ever since he was a kid); Muscular weakness; Radiotherapy (of his head and lung for his cancer); Small cell lung cancer (In liver and lymph nodes; brain metastases)
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:not stable; going up and down; Test Name: pulse; Result Unstructured Data: Test Result:pulse incomplete
CDC Split Type: USPFIZER INC2021368470

Write-up: Fluid in his bottom right lobe of his lung where the cancer is; Inflammation in the bottom of his lung; in lower right lobe of lung; Blood pressure isn''t stable; going up and down; Blood pressure issues; Exhausted; fatigue; Trying to control his blood pressure and his pulse issues, pulse incomplete; Muscle weakness was severely progressing; Bad reaction to the Covid vaccine; Blood clot on his lung; Raspy voice; the patient had been sick; Moderate headaches; Passed away; This is a spontaneous report from a contactable consumer (patient) based on the information received by Pfizer from Pharmaceuticals (Manufacturer control number 2020CAT00505). A 74-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on an unspecified date at single dose for COVID-19 immunisation. Co-suspect drug included amifampridine phosphate (FIRDAPSE) orally, from 18Sep2020 to an unspecified date at 10 mg thrice daily, from 02Oct2020 to an unspecified date at 20 mg thrice daily, for Lambert-Eaton myasthenic syndrome. Medical history included Lambert-Eaton myasthenic syndrome (he could not walk without FIRDAPSE), migraine ever since he was a kid, small cell lung cancer (in liver and lymph nodes; brain metastases), metastases to liver, metastases to lymph nodes, radiotherapy of his head and lung for his cancer, gait disturbance from an unknown date and unknown if ongoing, muscular weakness from an unknown date and unknown if ongoing. Concomitant medications included pantoprazole, acetylsalicylic acid (ASPIRIN (E.C.), furosemide. The patient experienced blood clot on his lung in Jan2021 with outcome of unknown, fluid in his bottom right lobe of his lung where the cancer was on an unspecified date with outcome of not recovered, inflammation in the bottom of his lung; in lower right lobe of lung on an unspecified date with outcome of not recovered, raspy voice in 2021 with outcome of recovered, blood pressure not stable; going up and down; blood pressure issues on an unspecified date with outcome of not recovered, exhausted; fatigue on an unspecified date with outcome of not recovered, sick in 2021 with outcome of unknown, trying to control his blood pressure and his pulse issues, pulse incomplete on an unspecified date with outcome of unknown, moderate headaches from 19Sep2020 with outcome of recovered, muscle weakness severely progressing on an unspecified date with outcome of unknown, 10 mg 3 times a day wasn''t enough (therapeutic product effect incomplete), on an unspecified date with outcome of unknown, he''d switch and do a couple doses of 15 mg and it was better but not enough (intentional product use issue) on an unspecified date with outcome of unknown, after he received the COVID vaccine, he experienced a bad reaction (unspecified) on an unspecified date with outcome of unknown. The events were reported as serious as involved hospitalization. The patient passed away on an unspecified date in Feb2021. It was not reported if an autopsy was performed. The clinical course of the events included the following information. On 21Sep2020, a spontaneous report was received from a consumer, via a company representative, regarding a 74-year-old male who was being treated with FIRDAPSE 10 MG (amifampridine). On 22Sep2020, additional information was received from a consumer. On 02Oct2020, additional information was received from a consumer and chemotherapy was added as a co-suspect. On 01Feb2021, additional information was received from a consumer via a company representative. On 09Feb2021, additional information was received from a consumer, and this case was determined to be the master case for cases 2021CAT00039 and 2021CAT00052 (both invalid, duplicate cases) and the information was merged into this case (2020CAT00505). This case was re-assessed as serious/unexpected, and COVID vaccine was added as co-suspect. On 18Feb2021, additional information was received from a consumer via a company representative. On 19Feb2021, additional information was received from a patient ambassador via a company representative. Medical history included LEMS (Lambert-Eaton myasthenic syndrome) and migraines. Concomitant products included: an unknown statin, pantoprazole, and acetylsalicylic acid (ASPIRIN) 81 mg. On 18Sep2020, the patient started treatment with FIRDAPSE 10 mg at 10 mg, 3x/day orally for LEMS. On 19Sep2020 and 20Sep2020, after starting the product, the patient experienced moderate headaches. On 21Sep2020, the patient did not experience a headache. On 22Sep2020, the patient experienced a headache that was "4/10." He had taken acetaminophen; aspirin; caffeine (EXCEDRIN) and ibuprofen as treatment and it "helped." The patient had not spoken to his HCP (health care provider) about the event but was going to call his HCP and ask to increase his dose of FIRDAPSE. The product was working and he was walking better, but he had heard people taking up to 80 mg a day. As of 22Sep2020, product use was ongoing and headaches were improved. On 02Oct2020, it was learned that his medical history included being prone to headaches (also reported as migraines ever since he was a kid) and "chemo" for small cell lung cancer stage 4 which was in his liver and lymph nodes. Concomitant products included furosemide. It was noted that the patient had been on the product for 4 to 5 days when he experienced his moderate headaches. He had the headaches for just a couple days, but he wasn''t sure if it was due to the FIRDAPSE or it was the chemo. He took "a couple" of ibuprofen and he was "alright." On an unspecified date, the patient was in contact with his HCP and he was told to "keep an eye on it" (presumed headaches) and see if it got worse. They agreed that it could have been the chemo or a "fluke" thing. He also spoke to his HCP about his FIRDAPSE dose of 10 mg, 3x/day not being enough. He would switch and do a couple doses of 15 mg and it was better, but not enough. His HCP thought he should be taking 20 mg 3x/day, so he was working with the patient''s insurance and pharmacy to get it changed. As of 02Oct2020, FIRDAPSE and chemo treatment were ongoing and moderate headaches were resolved (reported as he''d been good for a few days). On 01Feb2021 and 09Feb2021, it was learned that on 02Oct2020, the patient''s FIRDAPSE dose increased to 20 mg, 3x/day. On an unspecified date, the patient received the COVID vaccine at an unreported dose, route, and frequency of administration for an unreported indication. After the patient received the COVID vaccine, he experienced a bad reaction (unspecified). Since 27Jan2021 (reported as since Wednesday, relative to 01Feb2021), the patient had been sick. On 31Jan2021, the patient went to the emergency room, and they thought he had a blood clot on his lung. Subsequently, he was admitted to the hospital. Initially, when the patient was in the hospital, they took all his medications away, including his FIRDAPSE, as the pharmacy was managing his medication. The patient wife was able to get the doctors to let the patient keep his FIRDAPSE in his room with him before he missed any doses because he could not walk without his FIRDAPSE. On an unspecified date in 2021, the patient had radiation of his head and lung for his cancer (previously reported medical history), and "they" (presumed his medical provider) said he could have a raspy voice and headache, which he did experience but then resolved. While in the hospital, the patient''s blood pressure was not stable. It went "up and down, up and down." He had fluid in the bottom right lobe of his lung, where the cancer was, and they could not "tap it" due to the blood pressure issues. They were trying to get the fluid out every other way they could. The doctors said he had inflammation in the bottom of his lung. He was given a "good dose" of prednisone, but he was just exhausted. They were trying to control his blood pressure and his pulse. When they got one of them "up," the other went "down." The doctors said that the patient''s LEMS had nothing to do with why he was in the hospital. His wife expressed her gratitude for the FIRDAPSE and how it had helped him. As of 09Feb2021, treatment with FIRDAPSE was ongoing. The patient was still in the hospital and not doing well, also reported that he was still the same, he had not improved but he had not worsened. The blood clot on his lung, blood pressure fluctuation and pulse issues, fluid in the bottom right lobe of his lung, inflammation in the bottom of his lung, and exhaustion were not resolved. The status of the bad reaction to the COVID vaccine was not reported. No additional information was provided. On 18Feb2021 and 19Feb2021, it was learned that the patient''s medical history included: muscle weakness and lung cancer with brain metastases. On unspecified dates, after starting FIRDAPSE, the patient''s muscle weakness began severely progressing, and he experienced fatigue. The weakness was worsening significantly, even after being on the medication (presumed FIRDAPSE). On 14Feb2021 or 15Feb2021, the patient was discharged from the hospital. On 18Feb2021, the patient took his last dose of FIRDAPSE. On 18Feb2021 or 19Feb2021 (reported as last night, relative to 19Feb2021; yet also reported as either 18Feb2021 or 19Feb2021), the patient passed away. The cause of death was unknown. A 74-year-old male, with a history of migraines and chemotherapy for metastatic small cell lung cancer, was taking an unknown statin, furosemide, pantoprazole, and Aspirin. He added FIRDAPSE for LEMS on 18Sep2020 and experienced headaches for a couple days, but he wasn''t sure if it was due to the FIRDAPSE or chemo. After COVID vaccine, he experienced a bad reaction (unspecified). Since 27Jan2021, he was hospitalized with a blood clot on his lung. He had brain and lung radiation for cancer. While in the hospital, he had fluid and inflammation in the bottom right lobe of his lung, where the cancer was, which count not be drained due to labile blood pressure. His muscle weakness began progressing and he experienced fatigue. In Feb2021, he was discharged on FIRDAPSE. A few days post-discharge, he died. Based on the information provided, the events were assessed as unrelated. Information on the batch/lot number has been requested.; Reported Cause(s) of Death: Passed away


VAERS ID: 1199422 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-28
Onset:2021-02-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Malaise, 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: 2021-02-25
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away from blood clot, did not feel well after 2nd shot


VAERS ID: 1205071 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Unknown  
Location: Ohio  
Vaccinated:2021-02-11
Onset:2021-02-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3251? / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9200? / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Blood test, Cerebral venous thrombosis, Cerebrovascular accident, Computerised tomogram, Contusion, Death, Fall, Intensive care, Ischaemic stroke, Pulmonary thrombosis, SARS-CoV-2 test negative, Skull fracture, Subdural haematoma, Syncope, Thrombectomy
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-04
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg Besylate Norvasc Lupin Donepezil HCL 10 mg Solco Eliquis 5 mg Apixaban BMS Losartan 50 mg Cozaar Aurobindo Simvastatin Oral 20 mg Aurobindo
Current Illness: none
Preexisting Conditions: Hypertensive and Atherosclerotic Cardiovascular Disease Hypertrophic Cardiomyopathy Alzheimer''s Disease Cataracts
Allergies: Chlorthalidone hypokalemia Dexamethasone Penicillin Hydroxymethylglutaryl-CoA (HMG-CoA) Statins-muscle cramps with statins
Diagnostic Lab Data: Transport to the Hospital via Emergency Unit for treatment and testing: Multiple blood tests and several CT scans were performed. On March 2, 2021 at 10:30 am moved to a Medical Center after a minor ischemic stroke. During the course of the illness and treatment several COVID-19 tests were performed and all showed negative results.
CDC Split Type:

Write-up: On February 18, 2021 between hours 18:20-18:40 and a week after taking the second shot, patient lost balance (fainting) at home, fell, bruised a rib and fractured skull, causing subdural hematoma (bleeding outside of the brain). Bleeding stopped and several CT scans were performed. Under medical supervision, an anticoagulant medication was stopped to allow for healing. On February 20, 2021, moved from ICU to regular hospital room and on February 23 moved to another hospital for intense rehabilitation. Within days a thrombus developed causing a minor Cerebrovascular Accident, which was immediately identified by a medical doctor and nursing staff. On March 2, 2021 at 10:30 am moved to a Medical Center for further treatment. An endovascular thrombectomy for the removal of a thrombus was performed by a doctor. After recovery in the Neurosciences Critical Care ICU, under amazing care by the doctors, further thrombi developed on patient''s lungs and around the bowel. Patient expired at 8:01 on March 4, 2021 due to Ischemic Complications of Thrombi/Thromboemoli.


VAERS ID: 1211001 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-22
Onset:2021-03-28
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6202 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8727 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain injury, Cerebral thrombosis, Cerebrovascular accident, Death, Endotracheal intubation
SMQs:, Angioedema (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-05
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High blood pressure; diabetes
Allergies:
Diagnostic Lab Data: 03/28. Flown to another state after suffering a massive stroke due to a blood clot in the brain 03/29. Put into surgery to try to relieve pressure on her brain due to the blood clot. 04/2. Removed breathing tube due to 80% brain loss. 04/05. Mom died. My kids found her while she was having the stroke and called 911 on 03/28.
CDC Split Type:

Write-up: Patient is deceased. Had a blood clot travel to her brain and causes an un recoverable stroke


VAERS ID: 1213306 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-01
Onset:2021-03-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Biopsy, Blood test, Cerebrovascular accident, Colonoscopy, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Pulmonary thrombosis, Thrombosis, Ultrasound scan, X-ray
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), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-07-01
   Days after onset: 116
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Biotin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hospitalization 3/27-3/31: CAT, X-ray, pap, MRI, colonoscopy, blood tests, echocardiogram Hospitalization 4/10 - present: CAT, MRI, echocardiogram, ultrasound, heparin drip, blood tests, biopsy
CDC Split Type:

Write-up: blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation


VAERS ID: 1213431 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-01
Onset:2021-03-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Infection, Platelet count decreased, Portal vein thrombosis
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA) 108 (90 Base) MCG/ACT Aerosol Solution inhaler Ammonium Lactate (LAC-HYDRIN) 12 % Lotion ibuprofen 600 MG Tablet
Current Illness: na
Preexisting Conditions: Mild intermittent asthma without complication
Allergies: Ciprofloxacin-ciproflox Hcl ErNausea/GI Upset Peanut
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted with massive portal vein thrombosis and low plt in setting of infection. Symptoms started one week prior


VAERS ID: 1218764 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-10
Onset:2021-04-06
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9089 / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9089 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Brain herniation, Cerebral haemorrhage, Cerebral mass effect, Chest X-ray abnormal, Computerised tomogram head abnormal, Condition aggravated, Deep vein thrombosis, Haemoglobin decreased, International normalised ratio increased, Leukaemia recurrent, Leukapheresis, Leukocytosis, Lung infiltration, Lung opacity, Oedema peripheral, Platelet count decreased, Prothrombin time prolonged, Respiratory viral panel, Subdural haemorrhage, Thrombocytopenia, Viral test negative, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carvedilol (Coreg), acyclovir, Lipitor, HCTZ, lisinopril, metformin, Ivosidenib (Tibsovo), Allopurinol (Zyloprim), Acetaminophen (Tylenol)
Current Illness: AML, CKD, T2DM, HTN, HLD
Preexisting Conditions: AML
Allergies: Sulfa drug, citrus, latex
Diagnostic Lab Data: INR 1.8. PT 20.1, PTT 24.7, WBC 102K, Hgb 6.7, platelet 57, respiratory viral panel negative. CXR: Patchy ground-glass opacities in the right upper lobe and right lower lobe. Mild interstitial infiltrates in the upper lobes bilaterally. Extensive DVT from the right common femoral vein through the distal popliteal vein. CT brain: Left occipital intraparenchymal hemorrhage measuring 5.8 x 2.8 x 3.1 cm as well as diffuse left hemispheric subdural hemorrhage measuring 11 mm, resulting in 16 mm rightward midline shift, subfalcine, and left uncal herniation.
CDC Split Type:

Write-up: Patient with Hx of AML received 1st dose COVID vaccine 2/10/2021, 2nd dose 3/4/2021. She developed DVT of the right leg, AML relapse. The patient has been diagnosed with AML back in 2016 and underwent several lines of therapy including chemotherapy with 7 and 3 and the last treatment was decitabine with maintenance treatment with ivosidenib. Having severe leukocytosis and right-sided leg edema with DVT raised concern about blast crisis and leukostasis. Patient was admitted to hospital and received. ceftriaxone and azithromycin for possible pneumonia. She underwent leukophoresis on the 4/6/2021, 4/7/2021. Patient received IV heparin gtt for DVT but later on was on hold given worsening thrombocytopenia. She was transferred from one hospital to another hospital. I do not think the development of DVT was due to COVID vaccine. But prior to COVID vaccine, patient was in AML remission.


VAERS ID: 1224177 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-24
Onset:2021-03-12
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular disorder, Death, Life support, Mobility decreased, Thrombosis
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), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot blocking blood flow to brain - 1st episode: ( 3/12/21) stabilized, minor limited movement left side - 2nd episode: (3/24/21) no blood flow to brain, death (maintained on life support for organ donation)


VAERS ID: 1224898 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-17
Onset:2021-03-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; NAPROXEN; PREGABALIN; TRAMADOL; METOPROLOL
Current Illness: AFib (Under treatment with Aspirin)
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; Scoliosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021389688

Write-up: Stroke due to a large blood clot to the brain; Stroke due to a large blood clot to the brain; Widespread blood clots in both of her arms; This is a spontaneous report from a contactable consumer (daughter). A 67-year-old female patient received the 2nd single dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, in the left arm, on 17Mar2021 (at the age of 67 years old, not pregnant at time of vaccination) (Lot number was unavailable since unable to locate or read the details), for COVID-19 immunisation. The patient''s medical history included ongoing atrial fibrillation, high blood pressure, and scoliosis. Concomitant medications included ongoing acetylsalicylic acid (ASPIRIN) for atrial fibrillation, naproxen, pregabalin, tramadol, and metoprolol. The patient never had a history of blood clots. There were no allergies to report. The patient had not received any other vaccines in the four weeks prior to receiving BNT162b2. The patient had received the first single dose of BNT162b2 on an unspecified date, in the left arm. The patient''s daughter stated that her mother suffered a stroke due to a large blood clot to the brain on 25Mar2021 at 12:30 am, requiring hospitalization. During hospitalization, a surgery to remove blood clot from the brain was needed. Hospitalzation lasted 12 days. The reporter added that in the week prior to the reporting, the mother ''passed'' (as reported) but had widespread blood clots in both of her arms. The patient required unspecified treatment due to the events and had not recovered at the time of the reporting. The events were considered also serious since life threatening and due to disability. The patient did not have COVID-19 prior to the vaccination and had not tested positive post vaccination. Information on lot/batch number has been requested.


VAERS ID: 1227979 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-19
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: 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 INC2021406715

Write-up: got clots all over the body; This is a spontaneous report from a contactable consumer. 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 as single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced got clots all over the body in Mar2021 and he passed away. Pfizer has not been reporting any effects of blood clot. The patient died on an unspecified date. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: got clots all over the body


VAERS ID: 1227980 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-27
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fall, Pain in extremity, Pulmonary thrombosis, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety (Her brother in law had anxiety about even getting the vaccine); Clot blood
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021406778

Write-up: Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer. A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation. Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date. The patient died on 02Apr2021. An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it''s too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he''s a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it''s better, by Friday he was making breakfast, fell and died. With his girlfriend she said what''s going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain


VAERS ID: 1230389 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Night sweats, Pulmonary thrombosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-25
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Letrozol 2.5 mg Vit D3 500 iu, Corgard, Synthroid
Current Illness: Metastic Breast Cancer
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever, severe night sweats, blood clots in lungs


VAERS ID: 1235815 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-03-25
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebral thrombosis, Cerebrovascular accident
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)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   Days after onset: 8
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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021410670

Write-up: stroke; Brain bleed; Brain blood clot; This is a spontaneous report from a contactable consumer via a Pfizer sponsored program named Corporate (Pfizer) Social Media Platforms. A 53-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 11Mar2021 13:15 as single dose for covid-19 immunisation. Medical history reported as none. The patient''s concomitant medications were not reported. The patient experienced brain blood clot on 25Mar2021 08:00 , stroke and brain bleed on an unspecified date. The patient was hospitalized for brain blood clot, stroke, brain bleed for 7 days. Therapeutic measures were taken as a result of brain blood clot, stroke, brain bleed included Ventillator. The patient died on 02Apr2021. An autopsy was not performed. The outcome of events was fatal. No other vaccine in four weeks; No covid prior vaccination. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Brain blood clot; stroke; Brain bleed


VAERS ID: 1237884 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-01-08
Onset:2021-04-03
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood creatinine increased, Blood urea increased, Chest X-ray abnormal, Condition aggravated, Death, Decubitus ulcer, Deep vein thrombosis, Dyskinesia, Dysphagia, Full blood count, Haematocrit decreased, Haemoglobin decreased, Hepatitis C RNA increased, International normalised ratio increased, Lung infiltration, Metabolic function test, Muscular weakness, Pleural effusion, Pneumonia, Red blood cell count decreased, Ultrasound Doppler abnormal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Liver infections (narrow), Haematopoietic erythropenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Calcium Carbonate, Ceftriaxone, Co-Q10, Cyanocobalamin, Lidocaine Patch 4%, Magnesium Lactate, Micro-K, Mirtazapine, MVI, Omeprazole, Senna-S, Tylenol , Venlafaxine, Anusol-HC cream , Chlorxihidine Gluconate Sol''n, Gabapentin, Met
Current Illness: Pneumonia, Abnormal blood levels and overall medical decline.
Preexisting Conditions: Exposed lumbar hardware, mulitple pressure injury, Pain, Dysphagia, Anemia, Chronic pain syndrome, HTN, GERD, A-fib, age-related osteoporosis, CKD, Chronic viral Hep C, Hx of MRSA, Hemiplegia and Hemiparesis following cerebral infarct, MDD, Insomnia, Anxiety, Dysarthria, Diverticulitis of the intestine, protein-calorie malnutrition, opoid dependence, Spondylosis without myelopathy or radiculopathy, Hx of DVT.
Allergies: Codeine, Celebrex, Diuretic
Diagnostic Lab Data: Chest X-ray ( 02/24 Diffuse bilateral infiltrates and 03/25/2021 Congestive failure with superimposed bilateral infiltrates and bilateral effusions) , Duplex Ultrasound of RLE and RUE= Extensive thrombus extending from the subclavian vein through the axilarry vein adn aslo involving brachial vein and radial vein and ulnar vein. DVT in popliteal vein. CBC and BMP- Multiple lab works were one. 02/24- BUN- 23, Crea- 1.10WBC- 13.93, RBC- 3.55, h/h- 8.8/29.1. INR- 1.3. 02/25- inr-1.6, 02/26- 4.2, 02/27 INR-5.5, She was on Lovenox bridge with Coumadin at the time and after high level of INR, Lovenox was then held.
CDC Split Type:

Write-up: Resident have had multiple PNA tx with IM Rocephin and IV Zosyn, Difficulty in swallowing, Elevated HCV RNA, 02/15 PCR Quant, ER visit following weakness and involuntary UE movements/jerking. Elevated amonia levels controlled with use of Lactulose. 02/22/2021 RUE and RLE extensive DVT. Worsening pressure wound and development of arterial wounds. Admitted to Hospice on 03/31/2021. Resident deceased on 04/03/2021.


VAERS ID: 1240013 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-09
Onset:2021-02-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure decreased, Computerised tomogram thorax normal, Death, Dyspnoea, Malaise, Pulseless electrical activity, Resuscitation, Thrombosis
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-04
   Days after onset: 51
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 51 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: chemo, acyclovir
Current Illness: multiple myeloma
Preexisting Conditions: multiple myeloma x 5.5 years
Allergies: none
Diagnostic Lab Data: HR 30s with low/no BP in ambulance. Team did CPR. CT after TPA showed no clots but he improved after TPA so still considering clot cause.
CDC Split Type:

Write-up: not feeling well and short of breath on 2/11/21, 2/12/21 more short of breath ambulance came. Went into PEA in ambulance with CPR. They gave TPA for suspected blood clot. He initially improved. He did not recover and died 4/4/21. He spent the entire time in hospital or TCU with complications. We brought him home 4/2 to die at home.


VAERS ID: 1255628 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-28
Onset:2021-04-14
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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: 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 INC2021416881

Write-up: died yesterday due to blood clots; This is a spontaneous report from a contactable consumer. A 55-year-old female patient (mother) received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 28Mar2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced blood clots and died due to the event. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested. ; Reported Cause(s) of Death: died yesterday due to blood clots


VAERS ID: 1255703 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Portal vein thrombosis, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (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 INC2021425367

Write-up: Patient died; portal vein thrombosis; thrombocytopenia; This is a spontaneous report from a contactable physician. A 50-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on an unspecified date 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 portal vein thrombosis and thrombocytopenia 2 weeks after first Pfizer vaccine. Patient died. The patient died on an unspecified date. It was not reported if an autopsy was performed. The outcome of the events portal vein thrombosis and thrombocytopenia was unknown. The outcome of the event unknown cause of death was fatal. Information on the lot/ batch number has been requested.; Sender''s Comments: The information available in this report is limited and does not allow a medically meaningful assessment of the case. Based on temporal association, a causal association between the reported events and BNT162B2 cannot be fully excluded. Case will be reassessed when additional information is available including medical history and concomitant drug information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and investigators, as appropriate. ; Reported Cause(s) of Death: Patient died


VAERS ID: 1255731 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Organ failure, Thrombosis
SMQs:, Lack of efficacy/effect (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021432758

Write-up: Hot a fever then full blown covid; Hot a fever then full blown covid; blood clot; organ failure; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer reported that a male patient of an unspecified age received bnt162b2 (BNT162B2), dose 2 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. Previously on an unknown date, the patient received the first dose of BNT162B2 vaccine. On an unspecified date, the patient experienced hot a fever then full blown COVID, blood clot and organ failure leading to patient death on an unknown 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: Drug ineffective; Covid-19; Blood clot; Organ failure


VAERS ID: 1256737 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-01
Onset:2021-04-20
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Public       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: 2021-04-20
   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: None
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Died blood clot in brain


VAERS ID: 1259454 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-29
Onset:2021-04-23
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal, Superior sagittal sinus thrombosis, Venogram abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
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: none
Current Illness: aneurysm, s/p coiling in 2014
Preexisting Conditions:
Allergies: noone
Diagnostic Lab Data: CTA and MRV 4/24 and 4/25. Large L frontal venous stroke.
CDC Split Type:

Write-up: venous sinus thrombosis of the superior sagital sinus, based on imaging likely occurred 1-2 weeks prior to presentation, ~ 1-3 weeks after vaccination no other clear reason for hypercoag state, no prior thromboembolic events, no h/o malignancy or rheumatological disease.


VAERS ID: 1261865 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death after experiencing blood clot to the lung


VAERS ID: 1263560 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-31
Onset:2021-04-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-22
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ? tramadol (ULTRAM) 50 MG Tab TAKE 1/2 TABLET BY MOUTH AT DINNER AND AT BEDTIME AND TAKE ONE TABLET EVERY 6 HOURS AS NEEDED. NOT TO EXCEED 6 TABLETS PER DAY ? butalbital-acetaminophen-caffeine (FIORICET, ESGIC) 50-325-40 MG Tab Take 1 Tab
Current Illness: ACTIVE MEDICAL PROBLEMS: Patient Active Problem List Diagnosis Date Noted ? Repeated falls 01/19/2021 Falls in home ? Weakness generalized 01/19/2021 ? Decreased mobility and endurance 01/19/2021 ? Neuropathy involving both lower extremities 05/07/2020 ? Chronic tension-type headache, intractable 05/07/2020 ? Palliative care patient 03/19/2020 ? Atrial flutter 03/05/2020 Seen in ER and started on eliquis and metoprolol ? Cervical (neck) region somatic dysfunction 02/06/2020 Now using a soft collar to support his head. Gets consistent head aches which he reports are like an ice pick in the top of his head. ? History of total replacement of right hip 6/27/16 10/14/2016 ? Primary osteoarthritis of right hip 05/12/2016 ? Allergic rhinitis 10/28/2015 ? BPH (benign prostatic hyperplasia) 10/02/2014 ? Degenerative disc disease, lumbar 01/15/2014 ? Mixed hyperlipidemia Hyperlipidemia ? Hypertension, benign Hypertension
Preexisting Conditions: ACTIVE MEDICAL PROBLEMS: Patient Active Problem List Diagnosis Date Noted ? Repeated falls 01/19/2021 Falls in home ? Weakness generalized 01/19/2021 ? Decreased mobility and endurance 01/19/2021 ? Neuropathy involving both lower extremities 05/07/2020 ? Chronic tension-type headache, intractable 05/07/2020 ? Palliative care patient 03/19/2020 ? Atrial flutter 03/05/2020 Seen in ER and started on eliquis and metoprolol ? Cervical (neck) region somatic dysfunction 02/06/2020 Now using a soft collar to support his head. Gets consistent head aches which he reports are like an ice pick in the top of his head. ? History of total replacement of right hip 6/27/16 10/14/2016 ? Primary osteoarthritis of right hip 05/12/2016 ? Allergic rhinitis 10/28/2015 ? BPH (benign prostatic hyperplasia) 10/02/2014 ? Degenerative disc disease, lumbar 01/15/2014 ? Mixed hyperlipidemia Hyperlipidemia ? Hypertension, benign Hypertension
Allergies: Dust Mold
Diagnostic Lab Data: Patient''s daughter states there were full body CT scans done while her dad was in the hospital with the clots. He was not admitted to my facility so I cannot see the labs or scans.
CDC Split Type:

Write-up: Per patient''s Daughter the patient developed blood clots in his small intestine on 4/13/2021 and died 4/22/21 with physicians unable to explain how or why he developed these clots while on apixaban. She requested his case be reported and reviewed in hopes it helps make the vaccines safer if that was what caused the clots.


VAERS ID: 1265810 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-03-21
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Death, Deep vein thrombosis, Feeling cold, Hyperhidrosis, Insomnia, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-18
   Days after onset: 47
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 27 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetic (other medical history: Dialysis, Diabetic); Dialysis (other medical history: Dialysis, Diabetic)
Allergies: Allergy (known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes
Diagnostic Lab Data: Test Date: 20210329; Test Name: Blood test; Result Unstructured Data: Test Result:blood clot; Test Date: 202103; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: PRPFIZER INC2021448033

Write-up: sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient''s spouse). A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation. Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient''s concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021. The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday). The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown. Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication


VAERS ID: 1266361 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-22
Onset:2021-04-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9096 / 1 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Abdominal sepsis, Asthenia, Death, Defaecation urgency, Gastrointestinal necrosis, Intestinal ischaemia, Metabolic acidosis, Septic shock, Thrombosis, Vomiting
SMQs:, Acute pancreatitis (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Toxic-septic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: healthy
Preexisting Conditions: My auntie had kidney transplant 20+ years ago. She has been on schedule with her kidney medication and routine checkup.
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: April 22, 2021 morning my auntie got her first dose of Pfizer vaccine. She happily shared here vaccine experience with family member and relative. April 23 morning, she told us she has severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already, then she has no more energy to talk. She got into the hospital and she was announced death right after midnight at 12:04 April 25th. Reason of death given is "septic shock secondary to ischemic bowel & intra-abdominal sepsis". But it is the blood clots issue that is causing it. I was told that after my auntie got into hospital the very next day after Pfizer vaccine, hospital later found out that my auntie has blood blockage issue that is causing blood couldn''t flow to her intestines. The acid in her blood was very high, 6+. After more than 6 hours without blood to her intestines, her intestines tissues start dying and turned black color. Doctor found out about this at the night of April 23, 2021 nighttime. April 22, 2021 morning is the day my auntie got her Pfizer covid vaccine. There is a very high chances of the Pfizer vaccine is causing the blood clots that lead to blood blockages.


VAERS ID: 1270988 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-06
Onset:2021-03-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Chills, Death, Haemarthrosis, Herpes zoster, Illness, Malaise, Pain, Pericardial drainage, Pericardial effusion, Pulmonary thrombosis, Pyrexia, Vena cava filter insertion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-27
   Days after onset: 18
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 100mg Amiodarone 100mg Furosemide 40mg & 20mg alternating days Aspirin 81 mg Omeprazole 20mg Forsinopril 5mg Allopurinol 100mg Cyclopento 1% 1 drop left eye daily Predn
Current Illness: None
Preexisting Conditions: Afib Congestive Heart Failure Kidney Disease COPD
Allergies: MetFormin HCI Losartan Patassium Zocor Cipro Lipitor Irbesartan
Diagnostic Lab Data: I am requesting her medical records from the hospital.
CDC Split Type:

Write-up: After 2nd Vaccine on 3/6/21, she became ill on 3/8/21, fever and chills was in bed all day on 3/9/21 with the same symptoms. Woke up on 3/9/21 with shingles, Her PCP was treating her with Famciclovir and Gabapentin for pain. She no longer had the fever or chills but still didn''t feel well. On 3/17/21 she was admitted at Medical Center which she was treated for a blood clot in her lung and for pericardial effusion. She was put on blood thinners which then caused a bleed in her hip bone. She had a surgery to put a filter in to stop more blood clots and to drain the fluid from her heart. She died on 3/27/21 around 3:30pm.


VAERS ID: 1281533 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: School       Purchased by: ?
Symptoms: Death, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-17
   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: Patient died 7 days later. Blood clot in lungs. Issues started 5 days after second dose.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot in the lungs, Death


VAERS ID: 1283410 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-10
Onset:2021-03-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / UN

Administered by: Other       Purchased by: ?
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Death
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)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-15
   Days after onset: 0
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine Alprozalan Combivent Serevent Incruse Montelucart Qvar
Current Illness: Asthma - emphagsema
Preexisting Conditions: Anxiety
Allergies: Aspirin Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had a stroke on March 15, 2021 as described as a blood clot in her brain. Medical personnel were unable to correct it surgically and she passed away that evening in the hospital. Death was the final result.


VAERS ID: 1284449 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 AR / SC

Administered by: Other       Purchased by: ?
Symptoms: Arterial thrombosis, Asthenia, Cardiogenic shock, Confusional state, Death, Deep vein thrombosis, Dyspnoea, Heart rate increased, Intracardiac thrombus, Lethargy, Malaise, Pain in extremity, Peripheral coldness, Pulmonary embolism
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (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), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-21
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Diltiazem, Hydralazine, Actos, Synthroid, Doxepin
Current Illness:
Preexisting Conditions: Diabetes, Afib, Hypertension
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 40 hours after second Pfizer vaccine, patient complained of pain in lower right leg, and a cold foot, lethargy, weakness, feeling unwell. 3 days later, shortness of breath, difficulty breathing, rapid heartbeat, and confusion began. Went to Medical center on 4/20/21, diagnosed with DVT, PE and clots in and around the heart and passed away on 4/21/21 of cardiac shock in the setting of pulmonary and arterial thrombosis.


VAERS ID: 1285078 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-11
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Atrial flutter, Death, Glucose tolerance impaired, Haemorrhage intracranial, Pain in extremity, Peripheral artery thrombosis, Peripheral coldness, Thrombectomy, Thrombophlebitis superficial, Ultrasound Doppler abnormal, Vasodilatation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Supraventricular tachyarrhythmias (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Lipodystrophy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: propranolol, other antihypertensive, antacid for GERD
Current Illness: none
Preexisting Conditions: hypertension, GERD, borderline DM, diagnosed while in rehab week before death - well controlled/no Rx.
Allergies: none
Diagnostic Lab Data: Available from Dr.
CDC Split Type:

Write-up: Patient was a well and active 92 year old man, who walked 2 miles daily with a walker. He received Covid vaccine dose 1 on 11 Jan. On or before 30 Jan, he noted pains in one leg while walking. Newly dilated veins on the lower leg were noted. On feb 2 a doppler US revealed a superficial saphenous vein venous thrombosis, also new onset A flutter. Aspirin begun. On Feb 5 he woke with a cold foot (same side) and was found to have an arterial thrombus from SFA through distal posterial tibial. He underwent emergency thrombectomy, went to rehab for recovery, on Feb 23 suffered intracranial hemorrhage and died on Mar 10.


VAERS ID: 1284864 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-01-29
Onset:2021-02-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / -

Administered by: Military       Purchased by: ?
Symptoms: Cardiac arrest, Disease recurrence, Myocardial infarction, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-15
   Days after onset: 41
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ELIQUIS; FUROSEMIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anemic; Bone infection; Clot blood; Diabetic; Gangrene; Surgery
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021477402

Write-up: blood clot in her leg; blood clot in her leg; Cardiac arrest; Heart attack; This is a spontaneous report from a contactable consumer (patient''s daughter). A 96-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration on 29Jan2021 (Lot Number: EL9265) as SINGLE DOSE for COVID-19 immunization. Medical history included blood clots in her legs from an unknown date and unknown if ongoing , diabetec, bone infection, surgery and anemic; all from an unknown date and unknown if ongoing; and a family history of gangrene from an unknown date and unknown if ongoing of her mother. Concomitant medications included apixaban (ELIQUIS) taken as blood thinner and furosemide (FUROSEMIDE) taken for an unspecified indication; both start and stop date were not reported. The patient previously had BNT162B2 (Lot Number: EL1283) dose 1 on 08Jan2021 for COVID-19 immunization. The facility where the most recent COVID-19 vaccine was administered was in the military facility. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 15Mar2021, the patient died due to a heart attack and cardiac arrest. The patient developed a blood clot in her leg and had to have her leg taken off. The date of surgery was 05Feb2021, not early Mar2021 like was originally stated at the hospital. The patient was admitted either on 01Feb2021 or 02Feb2021 and discharged on 23Feb2021. They had a bunch of bad weather and then they put the patient in the nursing facility for about a month and when she was brought home she had a heart attack and died due to cardiac arrest. She doesn''t know about the blood clot and this being related to the COVID vaccines but the patient had surgery a week after she had her second shot. The heart attack was on 15Mar2021. The patient had a history of blood clots in her legs before and she had problems with that so that might of made it worse but she doesn''t know for sure. The patient died on 15Mar2021. An autopsy was not performed. The outcome of the event blood clot in her leg was unknown. No follow-up attempts are possible; information about lot/batch number has been obtained.; Reported Cause(s) of Death: heart attack; cardiac arrest


VAERS ID: 1288839 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-02-20
Onset:2021-04-23
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood disorder, Death, Thrombosis
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (broad), 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: 2021-04-23
   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: Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: Patient passed away on 4/23/21 and had blood clots throughout body. Patient did not have any other symptoms that were reported. Patients family requested a VAERS report be submitted.


VAERS ID: 1292206 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-31
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pulmonary fibrosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme blood clots in lungs and legs


VAERS ID: 1303074 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest tube insertion, Death, Deep vein thrombosis, Lung neoplasm malignant, Pain in extremity, Pulmonary mass, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   Days after onset: 25
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: Anti-rejection medications status-post solid organ transplants
Current Illness: When went to hospital with concern for clots from vaccination, it was discovered that he had a lung nodule which was found to be cancerous.
Preexisting Conditions: Previous transplants of kidneys x 2, and pancreas. Broken ankle 2 years prior.
Allergies: Unkinown
Diagnostic Lab Data: Wife reported the event to the Coronavirus Hotline/Poison Center; she did not have his medical records from the hospital. Reported information on this from is from the wife.
CDC Split Type:

Write-up: 1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021 2 days after 2nd dose, he developed severe pain in both legs. He was taken to the hospital where clots were diagnosed in both legs and groin area. A previously undiagnosed lung nodule was found and he was given a cancer diagnosis. He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission. Over the following weeks, he had a permanent lung drain placed. He died on May 5th or 6th at home. No autopsy performed.


VAERS ID: 1304689 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-04-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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: 2021-04-22
   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: Lisinopril
Current Illness: High Blood Pressure, Diabetic
Preexisting Conditions: High Blood Pressure, Diabetic
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot


VAERS ID: 1320362 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-05-06
Onset:2021-05-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8633 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021517148

Write-up: patient passed away, due to what was being told as possible blood clot in lungs; This is a spontaneous report from a contactable consumer. A 70-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06May2021 (Lot Number: ER8633) (at the age of 70-year-old) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient did not experienced COVID-19 prior or post vaccination. The patient passed away, due to what was being told as possible blood clot in lungs (on 07May2021). The event was serious (fatal) and required emergency room visit. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: blood clot in his lungs


VAERS ID: 1320378 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-20
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Deep vein thrombosis, Laboratory test
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-12
   Days after onset: 41
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: INSULIN; SIMVASTATIN; HYDROCHLOROTHIAZIDE; COREG; PROTONIX [OMEPRAZOLE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal; Clot blood; Diabetes; High cholesterol; Kidney stone; Liver cirrhosis; Pacemaker insertion (cardiac); Sarcoidosis; Thrombocytopenia; Vena cava filter insertion
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: lab tests; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210322; Test Name: lab tests; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC2021528357

Write-up: DVT was twice as bad; death/natural process; This is a spontaneous report from a contactable Nurse reporting for reporter''s husband. A 78-year-old male patient received bnt162b2 (reported as COVID vaccine), dose 2 via an unspecified route of administration on 20Mar2021 (Lot Number: EN6201; Expiration Date: 30Jun2021) as 2nd dose, single (at the age of 78-year-old) for COVID-19 immunisation. Medical history included diabetes, Liver cirrhosis, thrombocytopenia, Kidney stone, sarcoidosis, blood pressure abnormal, high cholesterol, pacemaker and they putted the IVC filter for blood clot. Concomitant medications included insulin, simvastatin, hydrochlorothiazide and omeprazole (PROTONIX), all taken for an unspecified indication, start and stop date were not reported; and carvedilol (COREG) taken for blood pressure, start and stop date were not reported. The patient previously received the first dose of bnt162b2 (Lot Number: EN6201; Expiration Date: 30Jun2021) on 27Feb2021 at the age of 78-year-old for COVID-19 immunization and experienced pulmonary embolism and deep vein thrombosis (DVT) on 12Mar2021, and went into the hospital 12Mar2021. Then the patient had the second COVID shot on 20Mar2021 and the reporter had taken him right back into the hospital couple days later because the DVT got twice as worst. The patient experienced DVT was twice as bad on an unspecified date in Mar2021, which required hospitalization on 22Mar2021. The patient underwent lab tests, he had lab tests on 22Mar2021 when he went in and he probably had them on 23rd and 24th of Mar2021. The reporter didn''t know what all the lab tests were done in the hospital. The patient died on 12Apr2021. The reporter stated they put Reason of death as natural process because she sent him in the Hospice. An autopsy was not performed. The outcome of event DVT was unknown. The reporter considered there was a causal relationship, when he got his second COVID shot on 20Mar2021 and then he went back in the hospital on 22Mar2021 and the DVT was twice as bad.; Sender''s Comments: Based on a positive temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported DVT. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: death/natural process


VAERS ID: 1330552 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-01-11
Onset:2021-01-29
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Death, Laboratory test
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)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-02-21
   Days after onset: 23
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 23 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: Diabetes
Preexisting Conditions: Diabetes
Allergies: Na
Diagnostic Lab Data: Labs done from01/29-02/19
CDC Split Type:

Write-up: Blood clot in brain causing stroke then death


VAERS ID: 1333991 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-25
Onset:2021-04-14
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Aortic thrombosis, Cardiac pharmacologic stress test, Death, Thrombosis
SMQs:, Embolic and thrombotic events, arterial (narrow), 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: 2021-04-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Stress test Lexiscan / Adenosine, Cardiology. 02/25/2021
CDC Split Type:

Write-up: Blot clot followed by fatal aortic thrombosis


VAERS ID: 1353752 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-01
Onset:2021-04-26
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER6204 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cautery to nose, Computerised tomogram abnormal, Coronary artery thrombosis, Death, Electrocardiogram abnormal, Epistaxis, Laboratory test, Myocardial infarction, Nasal cavity packing, Thrombosis, Thrombosis mesenteric vessel
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Ischaemic colitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-03
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plavix, Lipitor, lisinopril, protonix, pottasium chloride,
Current Illness: ETOH, Smoker
Preexisting Conditions: HTN, CAD/CABG, hx of CVA, heavy ETOH, smoker
Allergies: nkda,none
Diagnostic Lab Data: 4/26 no tests, routine epistaxis care in nasal cavity provided- rhinorocket then cautery with ENT. 5/1 extensive labs, ECG and CT imaging done at MVH and MGH facilities.
CDC Split Type:

Write-up: He received both doses March 2021. second dose on 3/26. on 4/26 presented to ER with Epistaxis, came to about a month after Pfizer series pt went to Hospital ER 3 times that week for care of what was thought nose bleeds from picking, and later ENT for care that required travel. Pt stopped Plavix use and 6 days later on 5/1 returned to Hospital ER with serious symptoms, developed multiple thrombotic events that lead to clotting of leg/bowel/coronary. Transferred to Hospital on 5/1/2021. Multiple MI events and expired at Hospital on 5/3/2021


VAERS ID: 1384989 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-16
Onset:2021-04-12
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT AVAILABLE / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, Anticoagulant therapy, COVID-19 pneumonia, Computerised tomogram abnormal, Computerised tomogram thorax, Death, Deep vein thrombosis, Fibrin D dimer increased, Full blood count, Hypoxia, Lung opacity, SARS-CoV-2 test positive, Scan with contrast, Ultrasound Doppler abnormal, Ventilation/perfusion scan, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (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), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibrutinib, amlodipine, benazepril, azithromycin, albuterol inhaler, rosuvastatin, cholecalciferol
Current Illness: Diagnosed with COVID "2 weeks ago" (COVID positive 3/26/21)
Preexisting Conditions: Chronic Lymphocytic Leukemia on Ibrutinib (immunocompromised)
Allergies: none
Diagnostic Lab Data: 2019nCoV amplified: 4/16/21 Positive, 4/17/21 Negative, 4/19/21 Negative CT Chest w/o contrast: 4/12/21 bilateral patchy groundglass consolidation is identified bilaterally in all lobes - consistent with diffuse COVID 19 pneumonia US Lower extremity venous doppler bilateral 4/18/21: Reason for Exam: elevated d.dimer and persistent hypoxemia. Nonocclusive DVT right posterior tibial vein. CTA Chest 4/18/21: Negative for PE NM LUNG SCAN PERFUSION PARTICULATE 4/19/21: Low probability for PE
CDC Split Type:

Write-up: Admitted to hospital 4/12/21 for acute hypoxic respiratory failure due to COVID-19 pneumonia. Treated with remdesivir (full course) and dexamethasone 10mg x1 then 6mg daily x 9 days. DVT treated with heparin IV Ibrutinib held -- CBC at baseline (WBC ranged 23.5 - 35.1) Infectious Disease MD ruled out other infections, including pneumocystis pneumonia Hypoxemia progressed to severe -- 60L high flow oxygen, unable to wean - patient does not want to be intubated On 4/22 the patient desired for comfort measures only and weaning of oxygen. The patient died on 4/25/21.


VAERS ID: 1385337 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-23
Onset:2021-04-20
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Blood test, Cerebral haemorrhage, Cerebrovascular accident, Computerised tomogram, Dementia, Depression, Disturbance in attention, Magnetic resonance imaging, Parkinson's disease, Seizure, Thrombosis, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-08
   Days after onset: 49
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin 2x''s a day.
Current Illness: Diabetes
Preexisting Conditions: Had a stent
Allergies: None
Diagnostic Lab Data: Hosptial completed MRI, ultrasound, CT scan, and blood work.
CDC Split Type:

Write-up: Was living happily and independently in a retirement community. After the second dose because losing his memory, focus, depression, followed by 2 strokes, brain bleed, blood clots, seizures, and a Dx of Parkinson''s and Parkinson''s dementia. He saw doctors monthly and never had any signs of any of these things.


VAERS ID: 1400337 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-27
Onset:2021-05-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autopsy, Back pain, Death, Hypoaesthesia, Malaise, Respiratory arrest, Thrombosis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-18
   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: Over the counter Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies to food or other products
Diagnostic Lab Data: An autopsy was completed. The final report is pending.
CDC Split Type:

Write-up: On May 18, 2021, Patient said he was experiencing severe back pain and that both of his arms had gone numb and he had vomited. Patient called his mother to come help him with the baby because he wasn''t feeling well. When she got there 30 minutes later he was not breathing. They were not able to revive him. He died of a blood clot in the front of his heart.


VAERS ID: 1402395 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-30
Onset:2021-04-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19 pneumonia, Chest X-ray abnormal, Cyanosis, Death, Decreased appetite, Deep vein thrombosis, Diarrhoea, Dyspnoea, Fibrin D dimer increased, Heparin-induced thrombocytopenia, Lymphopenia, Multiple organ dysfunction syndrome, Oxygen saturation decreased, Pain, Respiratory distress, Respiratory failure, SARS-CoV-2 test positive, Shock
SMQs:, Anaphylactic reaction (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-24
   Days after onset: 23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: finasteride, tamsulosin
Current Illness:
Preexisting Conditions: multiple sclerosis, obesity
Allergies: ticfidera (diarrhea), tomato plant (hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite. ED visit 4/8/2021, lymphopenia noted, COVID PCR positive. Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis. "Deteriorated quickly despite maximal medical management" per Discharge Summary. Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock. Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.


VAERS ID: 1404274 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-01
Onset:2021-03-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocardial infarction, Sudden death, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-07
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, statin
Current Illness:
Preexisting Conditions: Diabetes, high blood pressure, high cholesterol
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death, sudden heart attack or blood clot


VAERS ID: 1410234 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Loss of consciousness, Medical induction of coma, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-15
   Days after onset: 10
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: Hay fever
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot?$g loss of consciousness-$g artificial coma ?$g death 10 days after vaccination


VAERS ID: 1411290 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-25
Onset:2021-03-25
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Autopsy, Death, Deep vein thrombosis, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-05
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, amlodipine, aspirin, calcium, vitamin D, Miralax, Synthroid, Mucinex, Colace
Current Illness:
Preexisting Conditions: Heart block, heart failure, COPD, diabetes, dementia
Allergies: Codeine, morphine, sulfa antibiotics
Diagnostic Lab Data: An autopsy performed on 4/15/21 found deep venous thrombi in both legs and emboli in both lungs. There are a few case reports of DVT following the COVID-19 mRNA vaccines. I did not conclude that this patient''s DVT was caused by the vaccine but was advised by supervisor to report the death anyway.
CDC Split Type:

Write-up: Death due to PEs in bilateral lungs caused by DVTs in bilateral legs.


VAERS ID: 1413234 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       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: 2021-05-25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TBD
Current Illness: Stomach cancer
Preexisting Conditions: TBD
Allergies: TBD
Diagnostic Lab Data: March 2021
CDC Split Type:

Write-up: Multiple blood clots that led to death on May 25, 2021.


VAERS ID: 1421500 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-18
Onset:2021-04-08
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiomyopathy, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-14
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Names unknown
Current Illness: Sarcoidosis
Preexisting Conditions: Sarcoidosis
Allergies: None known
Diagnostic Lab Data: Respirator - tests unknown
CDC Split Type:

Write-up: Covid 19, Blood Clot in Lung, Myocardia


VAERS ID: 1426917 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-25
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: 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 INC2021683252

Write-up: pass away recently due to blood clots; This is a spontaneous report from a contactable nurse (parent) and consumer. The nurse reported similar events for three patients. This is the first of three reports. A female patient of an unspecified age 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 immunization. The patient''s medical history and concomitant medications were not reported. The patient pass away recently due to blood clots on an unspecified date. The patient died on an unspecified date. It was not reported if an autopsy was performed. It was reported that even though the event was outside of reporting timelines & deemed by the PI to be unrelated to study drug. Information on batch and lot number is requested.; Sender''s Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported event of thrombosis with fatal outcome due to temporal relationship. However, the reported event may possibly represent intercurrent medical condition in this patient. There is limited information provided in this report. Additional information is needed to better assess the case, including complete medical history, diagnostics including vascular imaging studies, coagulation panel and autopsy results, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.,Linked Report(s) : PFIZER INC-2021688670 same reporter, event and suspect drug; different patient; PFIZER INC-2021688671 same reporter, event and suspect drug; different patient; Reported Cause(s) of Death: blood clots


VAERS ID: 1426921 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-25
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: 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 INC2021688670

Write-up: Patient died due to Blood clots; This is a spontaneous report from a contactable nurse. This nurse reported similar events for 3 patients. This is the 2nd of 3 reports. A female patient of an unspecified age 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 unknown dose, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient pass away recently due to blood clots. The agency also stated that all 3 of these nurses had received the Pfizer vaccine. Document submitted for patient even though the event was outside of reporting timelines and deemed by the PI to be unrelated to study drug. It is not reported if autopsy was performed. information about lot/batch number has been requested.; Sender''s Comments: Based from current drug profile, the event thrombosis is assessed as unrelated to suspected drug BNT162B2 . It is difficult to provide possible cause of the event due to limited patient medical information or background.,Linked Report(s) : PFIZER INC-2021683252 same reporter, same drug, same event, different patient;PFIZER INC-2021688671 same reporter, same drug, same event, different patient; Reported Cause(s) of Death: Blood clots


VAERS ID: 1433813 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-02-28
Onset:2021-05-11
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Acute respiratory failure, COVID-19, Condition aggravated, Coronary artery thrombosis, Death
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-12
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death 5/12/2021 Causes of death listed on death certificate: 1) Acute Myocardial Infarction 2) Acute Coronary Artery Thrombosis 3) COVID-19 Other: Acute Respiratory Failure


VAERS ID: 1458628 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-17
Onset:2021-04-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac failure, Cerebrovascular accident, Death, Dyspnoea, Intensive care, Laboratory test, Pulmonary thrombosis, SARS-CoV-2 test negative, Thrombosis
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-02
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Yes a lot of test and lab were done, but like I said previously they have not given me his medical records so I don''t know all the exact dates to everything yet.
CDC Split Type:

Write-up: My previously healthy brother received the Pfizer vaccine (1st dose) and 4 days after he was hospitalized with shortness of breath, heart failure, blood clots in his arm, lungs and leg along with a stroke and many medical conditions kept arising as he was hospitalized. He was in the CICU for a week and a half. Unfortunately, my brother passed away from the Pfizer vaccine. Until his last day the doctors still "didn''t know" what was wrong with him. A lot happened during his hospital stay, but this is just a brief statement. They have been keeping his medical records from me. They tested him repeatedly there from covid and he wa salways negative. They had no other explanation to what was happening and all along they wanted it to be COVID-19 and were so quick to say it was not the vaccine.


VAERS ID: 1466124 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-13
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: 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 INC2021807766

Write-up: blood clots; This is a spontaneous report from a contactable physician via a sales representative. 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 for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient died one week after receiving Pfizer COVID vaccine, autopsy confirmed blood clots. Event took place after use of product. Information on the lot/batch number has been requested.; Sender''s Comments: A possible contributory role of the suspect drug to the reported event "blood clots" cannot be completely excluded based on temporal association. This case will be re-assessed when additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identifies as part of this review, as well as any appropriate action in response, will be promptly notifies to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: blood clots


VAERS ID: 1483629 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-29
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Cytokine storm, Deep vein thrombosis, Haemophagocytic lymphohistiocytosis, Nervous system disorder, Platelet count
SMQs:, Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Platelets; Result Unstructured Data: Test Result:15,000
CDC Split Type: USPFIZER INC2021879891

Write-up: Neurologic damage (Shaking/memory/speech/motorskills); DVT; Afib; Secondary hlh; Cytokine Storm; This is a spontaneous report from a Pfizer-sponsored program. A female patient of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 29Mar2021 as single dose for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection; Lot number: unknown), via an unspecified route of administration on unspecified date as single dose for COVID-19 immunization. The patient experienced neurologic damage (Shaking/memory/speech/motorskills), DVT, Afib, secondary hlh, cytokine storm on 2021. The patient was hospitalized for neurologic damage (Shaking/memory/speech/motorskills), dvt, Afib, Secondary hlh and cytokine storm from 12Apr2021 to an unknown date. The patient underwent lab tests and procedures which included platelet count: 15,000. The patient died on 12Jun2021. It was not reported if an autopsy was performed. The outcome of all the events was Fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: Based on temporal association, the causal relationship between BNT162B2 and the events cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available.,Linked Report(s) : US-PFIZER INC-2021879892 same source, different reporter/ patient; Reported Cause(s) of Death: The Pfizer shots killed my beautiful mother


VAERS ID: 1491659 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-01
Onset:2021-05-01
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood test, Cerebral thrombosis, Cerebrovascular accident, Computerised tomogram abnormal, Confusional state, Coronary artery thrombosis, Death, Dysarthria
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-31
   Days after onset: 30
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: Insulin, pain meds, bladder meds, anxiety meds
Current Illness: None
Preexisting Conditions: Type II diabetes, fibromyalgia, arthritis
Allergies: Shrimp,
Diagnostic Lab Data: CT scans, blood work on May 24th. Major strokes, blood clots, possible heart attack. Death reported as related to complications to type II Diabetes
CDC Split Type:

Write-up: Blood clots, strokes, death I believe that there were subtle unrecognized signs starting in March - off balance, slurred speech, confusion- thought to be diabetes related. I would have her check her sugar and it would be fine, but I dismissed it as a good thing that her sugar was ok. It didn?t cross my mind until the major strokes that it could be related to the vaccine. She had major strokes in May as a result of blood clots in heart and head. I strongly believe that her death is related to the vaccine. She was well, and had her diabetes under control, and three months after getting the vaccine, she was dead.


VAERS ID: 1500766 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-18
Onset:2021-03-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN602 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN607 / 2 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Amnesia, Balance disorder, Brain operation, Death, Thrombosis
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-30
   Days after onset: 69
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, mylaxocam, tylenol
Current Illness: None
Preexisting Conditions: Carpal tunnel left wrist, Arthritis right shoulder, Gi problems ie kidney stones.
Allergies: Unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death


VAERS ID: 1507895 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-01
Onset:2021-04-01
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-31
   Days after onset: 60
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: INSULIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis; Fibromyalgia; Type II diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100924269

Write-up: Blood clots; strokes; This is a spontaneous report from a contactable consumer. A 81-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: FT8886), via an unspecified route of administration, administered in left arm on an unknown date in Feb2021 (at the age of 81-year-old) as dose 2, single dose for COVID-19 immunisation. Medical history included type II diabetes, arthritis and fibromyalgia. Prior to the vaccination, the patient was not diagnosed with COVID. The patient taken other medications in two weeks: insulin shots, prescription pain medications, urine medications and anxiety medications. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: not reported), administered in left arm on an unknown date in Feb2021 (at the age of 81-year-old) as dose 1, single for COVID-19 immunisation. The patient did not receive other vaccine in four weeks. Post vaccination, the patient had not been tested for COVID. On an unknown date in Apr2021, the patient had blood clots and strokes. The events resulted in emergency room/department or urgent care, hospitalized for 7 days. The patient did not receive any treatment in response to the events. The patient died on 31May2021. An autopsy was not performed. Cause of death was reported as blood clots and strokes. Outcome of the events was fatal. Information about lot/batch number has been requested.; Reported Cause(s) of Death: Blood clots; strokes


VAERS ID: 1508935 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arkansas  
Vaccinated:2021-02-01
Onset:2021-02-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Blood viscosity increased, Body temperature, Cough, Fatigue, Myocardial infarction, Product use issue, Pyrexia, Sinusitis, Thrombosis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vasculitis (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-21
   Days after onset: 20
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dialysis (she had been on dialysis for 5 years before the shot)
Preexisting Conditions: Medical History/Concurrent Conditions: Renal failure (had renal failure before the shot.)
Allergies:
Diagnostic Lab Data: Test Date: 20210216; Test Name: blood work; Result Unstructured Data: Test Result:it was fine; Test Date: 202102; Test Name: temperature; Result Unstructured Data: Test Result:98-104
CDC Split Type: USPFIZER INC2021885179

Write-up: Stated that the coroner wrote the cause of death as a blood clot that caused a heart attack.; tired; coughing; sinus infection; throwing up; fever/started running a temperature; Stated that the coroner wrote the cause of death as a blood clot that caused a heart attack.; Stated that she went from her blood being thin to as thick as pancake syrup after the second shot; Patient previously received first dose of Moderna shot; This is a spontaneous report from a contactable consumer. A 62-year-old female patient received BNT162B2 [COVID-19 Vaccine-Manufacturer Unknown; Solution for injection; Lot number: unknown] via an unspecified route in left arm on an unspecified date in Feb2021 as single dose for COVID-19 immunization. Medical history of the patient included renal failure [she had been on dialysis for 5 years before the shot. Stated that she had renal failure before the shot. dialysis blood work done on 16Feb2021] and dialysis. Concomitant medications were not reported. Patient previously received first dose of Moderna shot via an unspecified route on an unspecified date in Jan2021 as single dose for COVID-19 immunization and experienced first shot left arm hurt. On an unspecified date in Feb2021, after receiving second dose of vaccination, patient started running a temperature which lasted for five days. On 14Feb2021, patient experienced coughing, throwing, sinus infection and on 15Feb2021 experienced being tired. Reportedly, four days after receiving second dose of vaccination patient started running temperature. The doctor asked patient to rotate with ibuprofen for a few days and during that time it was 98-104. Patient was given medicine for coughing and Zofran to settle her stomach because she was throwing up, all of this was after the second shot. On Friday, patient went to the doctor and they never drew blood work, but patient had blood work from where she does dialysis. The doctor said it was fine, patient worked 40 hours per week and with dialysis and was told that she was healthy despite renal failure. Patient was told that she would be okay in 3-4 days. Two days later on Sunday night at 20:05 patient passed away. The coroner wrote the cause of death as a blood clot that caused a heart attack. Patient did not have an autopsy done. Patient blood was as thick as pancake syrup. Reporter mentioned that sometimes they would pull the needle on dialysis and it would take 30 minutes to stop the bleeding because her blood was so thin. Patient went from her blood being thin to as thick as pancake syrup after the second shot on an unspecified date in 2021. Reporter said it was odd all of the coughing, throwing up, fever and blood thickening that happened after the second shot was given. Patient had been on dialysis for 5 years before the shot and had renal failure before the shot. Dialysis blood work was done on 16Feb2021. Reporter (patient husband) was very observant of wife and takes care of her. After the second shot patient missed whole a week of work [from 15Feb through 21Feb] and had never missed work. Patient was tired, fever, coughing and throwing up. Reporter believes that the medication caused all of these issues. Patient received treatment in response to the events fever, coughing, sinus infection and throwing up. Outcome of the event blood clot that caused a heart attack was fatal, for fever was recovered/resolved with sequel and for other events were unknown. Information on Lot/Batch information has been requested.; Reported Cause(s) of Death: blood clots leading to heart attack; blood clots leading to heart attack


VAERS ID: 1509660 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arterial thrombosis, Autopsy, Malaise, Pain in extremity, Pyrexia, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-06-19
   Days after onset: 58
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: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed. Next day he went back to work. Pt showed no symptoms until the month of June when he started complaining about pain in both arms. He was using a heating pad on his shoulders to help with the pain. He was taking Aleve for the pain but it was not helping so he no longer wanted to take it. He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon. He wasn''t feeling well the morning of June 18th, 2021 but continued working. He only wanted something light to eat since he didn''t feel well and was headed to bed. When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed. She turned him around and found him unresponsive. She contacted 911 and he was taken to Medical Center ER. They were not able to revive him. County conducted an autopsy where they found a blood clot in left artery.


VAERS ID: 1889278 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-04
Onset:2021-06-19
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-19
   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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clots in the lungs cardiac arrest sever headache


VAERS ID: 1519067 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-30
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Anticoagulant therapy, Catheter directed thrombolysis, Computerised tomogram abnormal, Death, Haemorrhagic stroke, Mesenteric artery thrombosis, Mesenteric vein thrombosis, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-11
   Days after onset: 11
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: Idiopathic Thrombocytopenic Purpura, Diabetes type 2, Hypertension
Allergies:
Diagnostic Lab Data: CTs showed mesenteric vein and arterial thrombi.
CDC Split Type:

Write-up: Patient received the 2nd Pfizer Covid-19 Injection on 4/27/2021. She began having severe stomach pain the following day that did not resolve. She went to the hospital and was admitted on 4/30/2019. She underwent CTs, Ultrasounds. Found that she had 1 blood clot in a mesenteric artery. A second CT performed 2 days later showed that she had a 2nd blood clot that formed in a mesenteric vein. She has a condition ITP where she does not clot very well, however, it was stable at this time. She was started on heparin drips which made no improvement to the clots. Lysis catheter inserted with a TPA drip. This resulted in hemorrhagic stroke. She was placed on palliative care and passed away on 05/11/2021.


VAERS ID: 1528255 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Idaho  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xeljanz
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100972826

Write-up: blood clots in her lungs; This is a spontaneous report from a contactable consumer or other non hcp from a Pfizer sponsored program. A 86-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), dose unknown via an unspecified route of administration on an unspecified date in 2020 (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunisation; tofacitinib citrate (XELJANZ), route of administration, start and stop date, batch/lot number and dose were not reported for an unspecified indication. The patient medical history and concomitant medications were not reported. The reporter stated that his neighbor was taking Xeljanz and got the COVID 19 vaccine (unknown manufacturer) and died from blood clots in her lungs. She died on an unspecified date and the family was blaming Xeljanz. The patient was diagnosis with blood clots about a month ago. She got COVID Vaccine around Christmas 2020. She was in hospital for 5 days with blood clots. The reporter inquired if vaccine cause blood clots. Seriousness of the event was reported as death and hospitalization. The action taken in response to the event for tofacitinib citrate was not applicable. The outcome of the event was fatal. It was not reported if an autopsy was performed. Follow-up attempts are needed. Information on the lot/batch number is expected.; Reported Cause(s) of Death: unknown cause of death


VAERS ID: 1530068 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-19
Onset:2021-03-24
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6027 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Death, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-05
   Days after onset: 12
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stroke on March 24, 2021. Widespread blood clots discovered on April 3rd, 2021. Death on April 5th, 2021.


VAERS ID: 1534829 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-26
Onset:2021-08-05
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LW0178 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Autopsy, Death, Embolism, 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: 2021-08-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Autopsy = embolism
CDC Split Type:

Write-up: Death from blood clot


VAERS ID: 1582941 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-26
Onset:2021-03-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Colon cancer, Condition aggravated, Death, Haemorrhage urinary tract, Nephrostomy, Prostate cancer, Pulmonary oedema, Thrombosis
SMQs:, Cardiac failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Prostate malignant tumours (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-09
   Days after onset: 128
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Darifenacin, tamsulosin, ciprofloxacin, duloxetine, prednison, abiraterone, mupirocin, psyllium, ammonium lactate, urea topical, acetaminophen, leuprolide, multivitamin
Current Illness: Stage 4 cancers of prostate and colon
Preexisting Conditions: None
Allergies: Penicillin, some statins
Diagnostic Lab Data: Hospital stays, then nephrostomy, then hospital then death. Water on lungs
CDC Split Type:

Write-up: Four days after the shot, patient started having blood clots in the urine. After a few weeks, was able to get back to normal but seemed to stimulate previously stable cancers into growth. Four days after the 2nd (3/19/21) covid shot blood clots started again.


VAERS ID: 1628789 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-12
Onset:2021-08-09
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood loss anaemia, COVID-19, Cerebrovascular accident, Death, Deep vein thrombosis, Endotracheal intubation, General physical health deterioration, Hypotension, Retroperitoneal haematoma, SARS-CoV-2 test positive, Shock haemorrhagic, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Hypovolaemic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-10
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban 5mg BID; Polycitra 1,100-334 mg/5mL TID; escitalopram 10mg daily; gabapentin 100mg TID
Current Illness:
Preexisting Conditions: CVA(2019), AFib (on Eliquis), pulmonary sarcoidosis, Gout, Kidney stones, HLD, CKD 3, coronary arteriosclerosis in native artery
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA Patient received Pfizer-BioNTech COVID Vaccines on 1/20/2021 and 2/12/2021. Presented to ED on 8/9/21 from acute rehab with complaints of unresponsiveness at Rehab. PMH of CVA (2019). 2 weeks prior to admission patient with admitted to hospital and diagnosed with pontine stroke. Patient was scheduled for TEE and underwent routine COVID test and tested positive. Pt caregivers reported patient showed no respiratory symptoms prior to this admission. During this stay patient was treated with empiric antibiotics, Decadron for 10 days and Lovenox for treatment of a DVT and discharged to acute rehab. Upon arrival to ED pt was hypotensive, intubated and found to have a large retroperitoneal hematoma. Pt was also started on Cefepime, Vancomycin, and Doxycycline. Patient diagnosed with acute hemorrhagic shock and, acute blood loss anemia. Patient continued to decline and family decided to withdraw care and initiate comfort care. Patient expired on 8/10/2021.


VAERS ID: 1646449 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-28
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: 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 INC202101000032

Write-up: developed it (blood clots) and died; This is a spontaneous report from a Pfizer-sponsored program from a non-contactable consumer or other non hcp. A female patient of an unspecified age 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 immunisation. The patient''s medical history and concomitant medications were not reported. The patient developed it (blood clots) and 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.; Reported Cause(s) of Death: developed it (blood clots) and died


VAERS ID: 1646847 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-01
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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: 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 INC202101024552

Write-up: developed widespread bloodclots; This is a spontaneous report from a contactable consumer for female patient (mother). A female patient of an unspecified age received bnt162b2 (COVID-19 vaccine), dose 2 via an unspecified route of administration on Mar2021 (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Historical Vaccine included first dose bnt162b2 for covid-19 immunisation on Feb2021. The patient developed widespread bloodclots on 2021 with fatal outcome. The patient died on 2021. It was not reported if an autopsy was performed. The clinical course was reported as follows: patient received the COVID-19 vaccine and developed widespread blood clots. Her first dose was in February, her second dose in March and 13 days later she was gone. The lot number for the vaccine, bnt162b2, was not provided and will be requested during follow up.; Reported Cause(s) of Death: Developed widespread bloodclots


VAERS ID: 1654195 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-27
Onset:2021-08-12
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Brain stem syndrome, Cerebral haemorrhage, Cerebral thrombosis, Cerebrovascular accident, Death, Myocardial infarction
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-20
   Days after onset: 8
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: 08/19/2021-08/20/2021
CDC Split Type:

Write-up: Blood clots resulting in many strokes, brain bleeding due to strokes resulting in crushing the Brain Stem, heart attacks and death


VAERS ID: 1655104 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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: USPFIZER INC202101091230

Write-up: blood clot to the brain; This is a spontaneous report from a contactable consumer (patient''s relative). A female patient (mother-in-law) of an unspecified age received unknown dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient died from a blood clot to the brain on an unspecified date. The reporter personally think that it was from the Pfizer shot. The patient died on an unspecified date. It was not reported if an autopsy was performed. Information about lot/batch number not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.; Reported Cause(s) of Death: blood clot to the brain


VAERS ID: 1677599 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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: Medical History/Concurrent Conditions: Hashimoto''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101139821

Write-up: Got a blood clot that went to his brain and died; This is a spontaneous report from a contactable consumer (patient''s friend) based on information received by Pfizer, on behalf of Moderna (Case: MOD21-136450). A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Lot number and expiration date was not reported) as dose 2, single for COVID-19 immunization. Medical history included Hashimoto''s disease. The patient''s concomitant medications were none. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Lot number and expiration date was not reported) as dose 1, single for COVID-19 immunization. On an unspecified date, the patient got a blood clot that went to his brain and had died on an unspecified date after 16-18 days of being fully vaccinated. 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: Got a blood clot that went to his brain and died


VAERS ID: 1679166 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Death, Dyspnoea, Dyspnoea exertional, Fear, Hepatic failure, Incomplete course of vaccination, Lethargy, Pulmonary thrombosis, Renal vascular thrombosis, Slow speech
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Renovascular disorders (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-15
   Days after onset: 35
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: Diabetes but was no longer needing medication. Kidney Disease, kidney had not changed in 5 years.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/5/2021 patient received 1st shot on 4/10/2021 noticed that she was lethargic, we thought that is might be her blood sugar but it was in normal range. we continued to check blood sugar daily thinking that was causing her to be lethargic and voice to be slow. 4/23/2021 my son and I spent the day with her noticing and she was getting worse but had also noticed that she was getting winded easily and would need to sit down. 4/26/2021 canceled 2nd covid shot. 4/30/2021 at about 1:30 pm she called me and said something was wrong something just happened she was scared! She called her Dr. and spoke to the the nurse PA. My sister was with her at the time so they checked for stoke signs none were found. Spoke to my mom through out the day on 5/1 & 5/2/2021 and she sounded out of breath and very lethargic. 5/3/2021 the Nurse PA called mom and said that she needed to go to the hospital where she stayed until she passed away on 5/15/2021. She had passed blood clots to her lungs then kidney and liver failure.


VAERS ID: 1679351 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-17
Onset:2021-02-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Cardiomegaly, Chest X-ray abnormal, Chronic left ventricular failure, Condition aggravated, Cough, Death, Immunodeficiency, Mental status changes, Oxygen saturation decreased, Peripheral swelling, Pleural effusion, Pneumonia, SARS-CoV-2 test positive, Subclavian vein thrombosis, Ultrasound Doppler abnormal, Weight increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (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), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), 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), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-03
   Days after onset: 105
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, allopurinol, amlodipine, aspirin, atorvastatin, calcitriol, donepezil, famotidine, tamsulosin, hydroxyzine, loperamide, losartan, metoprolol succinate, oxybutynin, prednisolone eye drops, prochlorperazine, montelukast, sodium
Current Illness:
Preexisting Conditions: CAD status post CABG x1 in 2014, ischemic cardiomyopathy, chronic diastolic CHF, paroxysmal atrial fibrillation, on Coumadin, pulmonary hypertension, sick sinus syndrome status post biventricular ICD, severe aortic stenosis status post TAVR, CKD stage 3, multiple myeloma, chronic anemia, hypertension and Alzheimer''s dementia.
Allergies: Amiodarone and tramadole
Diagnostic Lab Data: 3/20/21 Chest xray: Cardiomegaly with changes of CHF and bilateral pleural effusions. Superimposed pneumonia is also consideration. This has progressed since the prior. 3/20/21: Nonocclusive thrombus left subclavian vein. 3/20/21: COVID 19 positive
CDC Split Type:

Write-up: He was noted to have had a change in his mental status as per nursing home staff. Over the night his saturation dropped to 61% on room air because the patient took off his oxygen bed saturation came back to 90s after oxygen was replaced. He does have occasional cough. He has developed worsening swelling in his legs and has gained 20 lb since February 14th. Was placed on dexamethasone, azithromycin, cefepime and vancomycin due to immunocompromised state and chest xray showing pneumonia. Also received remdesivir. Resolved and discharged on 3/26/21. Came back on 4/27/21 for 8 days due to acute hypoxic respiratory failure and found to have CHF exacerbation. Was put on Hospice. Died 6/3/2021


VAERS ID: 1693704 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-08
Onset:2021-05-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Autopsy, Death, Pulmonary thrombosis, Toxicity to various agents
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Drug abuse and dependence (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-23
   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: none
Current Illness: none
Preexisting Conditions: depression, anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The decedent was found deceased at home on 05/23/2021. The decedent''s cause of death is acute fentanyl toxicity. The pathologist found blood clots in her lungs during autopsy, and she was concerned the blood clots may be related to the vaccine she received on 05/08/2021.


VAERS ID: 1694456 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Death, Diarrhoea, Fatigue, Nausea, Pain, Thrombosis
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The first dose which was on 7/29/21 for Covid 19.
Other Medications: Memantine, Retevmo, men''s one multivitamin, hydrocodone/aspirin (not regularly)
Current Illness: Stage 4 lung cancer, mild side effects after 1st and 2nd shot, sinus infection.
Preexisting Conditions: Stage 4 lung cancer - diagnosed 03/2021
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result.


VAERS ID: 1696271 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-09
Onset:2021-09-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

Administered by: Private       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: 2021-09-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Liver cirrhosis, DMII
Allergies: Metfomin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had vaccine on 9/9. Four days later he presented at local emergency room with blood clots in both legs. He died at the hospital the same day.


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: 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: 1753250 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-08-31
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Anxiety, Arthralgia, Blood culture negative, Bursitis, COVID-19, COVID-19 pneumonia, Coronary artery thrombosis, Culture negative, Death, Dyspnoea, Endotracheal intubation, General physical health deterioration, Hypervolaemia, Intensive care, Laboratory test normal, Lumbar radiculopathy, Mechanical ventilation, Oxygen saturation decreased, Positive airway pressure therapy, Rotator cuff repair, SARS-CoV-2 test positive, Tachycardia, Ultrasound Doppler abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-26
   Days after onset: 26
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: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler ALPRAZolam (XANAX) 1 MG tablet atenolol (TENORMIN) 100 MG tablet benzonatate (TESSALON) 100 MG capsule busPIRone (BUSPAR) 10 MG tablet DULoxetine (CYMBALT
Current Illness: 8.11.21: Office visit - plans to schedule - rotator cuff repair 8.16.21: Office visit - left hip pain (trochanteric bursitis, lumbar radiculopathy) COVID-19 positive 8.31.21
Preexisting Conditions: Rheumatoid arthritis involving multiple sites (HCC) Fibromyalgia HTN (hypertension) Tremor, essential Fatigue Morbid obesity (HCC) OSA (obstructive sleep apnea) Nocturnal hypoxemia Knee pain OA (osteoarthritis) of knee S/P total knee arthroplasty Pinguecula of both eyes Myopia of both eyes Hypothyroidism, unspecified type Bilateral hip joint arthritis Need for vaccination Screening, lipid Obesity hypoventilation syndrome (HCC) Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia (HCC) Obesity hypoventilation syndrome (HCC)
Allergies: Dilaudid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deceased (9.26.21); Hospitalized due to COVID-19 (9.2.21); COVID-19 positive (8.31.21); Fully vaccinated Admission Date: 9/2/2021 Died 9/26/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute hypoxemic respiratory failure (HCC) [J96.01] COVID-19 [U07.1] HOSPITAL COURSE: Patient is a 65 y.o. female with a PMHx of COPD not on home oxygen, HTN, Hypothyroid, RA on immunomodulator therapy who was admitted for AHRF secondary to Covid pneumonia. Completed 4 days of dexamethasone, 3 days of remdesivir so far. Bcx, other infectious work-up have been negative. Going intermittently between HFNC and BiPAP, stays relatively comfortable without additional work of breathing. She has been responding well to once/day diuresis. Multiple conversations at that time were held with the patient, who has elected to be DNR/DNI - okay with vasopressor medications if needed. After transfer out of the ICU she completed dexamethasone, remdesivir, diuresis as needed- she developed an AkI that resolved. She was able to alternate between HFNC and BiPAP but developed hypoxia despite continuous BiPAP at 100%. She was readmitted to the ICU on 9/11 and was unsure of her code status to be DNR or FULL. Overnight she remained on continuous BiPAP with O2 sats in the high 80s. A CTA to rule out PE was unable to be performed given her respiratory status, U/S showed no signsof DVT. On 9/12 Patient had increased work of breathing and anxiety, especially with repositioning and requested to be FULL CODE and was electively intubated for hypoxic respiratory failure 2/2 COVID-19 PNA. Following intubation, the patient did develop worsening urine output and AKI. She ultimately was started on CRRT for volume overload. With volume overload, her O2 requirement did improve somewhat, but she still had significant ventilatory needs due to her COVID-19 pneumonia. Patient also had persistent tachycardia during her hospital stay. Her serotonergic medications were held to rule out serotonin syndrome, repeat cultures were obtained without any growth, and extremity ultrasounds were performed which did show equivocal left coronal DVT. Patient was started on heparin drip for this possible DVT. Due to the persistent high ventilatory needs, goals of care were discussed with the family. It was agreed that tracheostomy tube placement was not in line with the patient''s goals of care, and due to her persistent refractory hypoxemia requiring high ventilatory needs, plan was made to transition patient to comfort care on Monday, 09/27/2021. On Sunday 9/26 patient had acute worsening in clinical status with decreasing oxygen levels. Based on patient''s families wishes for the patient to be with her husband upon passing the patient was made comfort care and passed away at 1108 AM. Date of Death: 9/26/21 Time of Death: 11:08 AM Preliminary Cause of Death: COVID-19


VAERS ID: 1753324 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-09-09
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Chest X-ray abnormal, Cough, Death, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Extubation, Gait disturbance, Hypoxia, Jugular vein occlusion, Lung opacity, Oxygen saturation decreased, Peripheral coldness, Physical deconditioning, Positive airway pressure therapy, Prone position, Pyrexia, SARS-CoV-2 test positive, Subclavian vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-28
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet albuterol (PROAIR HFA) 108 (90 BASE) MCG/ACT inhaler ALPRAZolam (XANAX) 0.5 MG tablet aspirin 81 MG chewable tablet CALCIUM PO CANNABIDIOL PO Cholecalciferol (VITAMIN D-3 PO) CRANBERRY PO Dalfampridine
Current Illness: 9.2.21 - office visit - annual physical - MS, HTN, asthma, polyps, knee pain, difficulty walking / cold legs Symptoms started 9.5.21. COVID-19 positive 9.9.21 (weak, coughing, difficulty walking)
Preexisting Conditions: Kidney congenitally absent, left Acute deep vein thrombosis (DVT) of right subclavian and IJ vein, noted 9/20/21 Acute allergic rhinitis Multiple sclerosis diagnosis in 1997. Fatigue Depression due to multiple sclerosis Neurogenic bladder Erectile disorder due to medical condition in male Anxiety Insomnia related to another mental disorder Gastroesophageal reflux disease without esophagitis Mild persistent asthma without complication Hypersomnia Chronic anemia Dyspnea on exertion At risk for falls Benign essential hypertension Pulmonary nodules History of adenomatous polyp of colon Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia, secondary to COVID-19 pneumonia Asthma Shock
Allergies: CatsAsthma/Shortness of Breath DogsAsthma/Shortness of Breath PenicillinsNausea Only, Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has expired / died (9.28.21); Hospitalized (9.15.21); COVID positive (9.9.21); fully vaccinated Discharge Provider: Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00] HOSPITAL COURSE: Patient is a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney. He was COVID (+) 9/9 (was vaccinated in the spring). He presented 9/15 with 10 days cough/SOB/fevers. In the ED, he was hypoxemic and would desaturate with activity. CXR showed patchy bilateral opacities. He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB. On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21). Doppler US 9/20 showed acute right IJ and right SC DVTs. He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak. He decompensated requiring BiPAP. He had been made DNR by family then comfort measures. He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death: 8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19


VAERS ID: 1757766 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-09
Onset:2021-09-07
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest tube insertion, Computerised tomogram thorax, Condition aggravated, Death, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Extubation, Infection, Lung opacity, Pneumonia, Pneumothorax, Pupil fixed, Renal cyst, SARS-CoV-2 test positive, Scan with contrast abnormal, Septic shock
SMQs:, Anaphylactic reaction (broad), Angioedema (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 (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (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), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-28
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyloprim Lipitor Synthroid Prinivil Bactrim
Current Illness: Shortness of Breath
Preexisting Conditions: Hypertension HLD Gout
Allergies: None
Diagnostic Lab Data: Covid positive TECHNIQUE: 1.Following the administration of intravenous contrast a CT angiogram of the chest/pulmonary arteries was performed. Sagittal and coronal images were generated. Dose reduction techniques were employed per ALARA protocol. 2. 3-D reconstruction of the pulmonary arteries was generated at a separate workstation and reviewed. FINDINGS: No pulmonary embolism. Normal caliber pulmonary arteries. Normal heart size. Trace pericardial fluid. Normal caliber aorta. Large areas of peripheral groundglass opacities filling both lungs. Findings consistent with COVID-19 pneumonia. No pleural effusion. No lymphadenopathy. Right renal cyst. No acute abnormality the included abdomen. IMPRESSION: 1. No pulmonary embolus. 2. Large areas of peripheral groundglass opacities filling both lungs. Findings consistent with COVID-19 pneumonia.
CDC Split Type:

Write-up: Pt is a 68 yoM vaccinated for COVID and hx of HTN, HLD, gout who presents with worsening shortness of breath found to have acute hypoxic respiratory failure 2/2 COVID pneumonia, given rapid worsening started on dexamethasone, remdesevir and barcitinib. He was also found to have a LLE DVT and given worsening oxygenation, possible PE. Pulm, Nephrology were consulted. He eventually needed to be intubated and then developed a pneumothorax requiring a chest tube. He then developed septic shock from superimposed HAP, completed therapy for it and meanwhile went into ARF, initially stable on diuretics, but eventually required HD. Had initial decline in neurologic status with nonresponsive R. Pupil, but unable to perform head imaging d/t clinical instability. Following another clinical decline on 9/26 where he was found to have another pneumothorax along with worsening s/s of infection. His family decided to make him comfort care at this point and plan to transition with terminal extubation and transfer to hospice scatterbed. He was terminally extubated and TOD was 9/28/21 0202.


VAERS ID: 1759168 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-22
Onset:2021-09-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Death, Dyspnoea, Thrombosis, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (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: 2021-09-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt.''s Sister states that after her brother received the 2nd dose of Phizer 09/22/2021, Pt. started experiencing shortness of breath and pain in the chest, Urgent Care visit 09/27/2021. Ultrasound preformed, treated with Updraft. Died 09/27/2021 2 Blood Clots located.


VAERS ID: 1759518 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-09-15
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute pulmonary oedema, Adenovirus test, Anticoagulant therapy, Aortic arteriosclerosis, Blood creatinine increased, Blood urea increased, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Cellulitis, Central venous catheterisation, Chest X-ray abnormal, Chills, Chlamydia test negative, Computerised tomogram head normal, Computerised tomogram thorax abnormal, Concussion, Condition aggravated, Confusional state, Death, Deep vein thrombosis, Dyspnoea, Enterovirus test negative, General physical health deterioration, Haemoglobin, Head injury, Human metapneumovirus test, Human rhinovirus test, Hypotension, Immunosuppression, Influenza A virus test negative, Influenza B virus test, Intensive care, Lung opacity, Lymphadenopathy, Mental status changes, Mycoplasma test negative, Oxygen saturation decreased, Pneumonia, Positive airway pressure therapy, Pulmonary oedema, Pyrexia, Respiratory distress, Respiratory failure, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sepsis, Septic shock, Splenomegaly, Systemic inflammatory response syndrome, Tachypnoea, Troponin increased, Ultrasound Doppler abnormal, Urinary tract infection, White blood cell count increased, White matter lesion
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic 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 (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), 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: 2021-09-19
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acalabrutinib 100 mg capsule aspirin 81 mg tablet cholestyramine (QUESTRAN) 4 gram packet gabapentin (NEURONTIN) 300 mg capsule rOPINIRole (REQUIP) 0.5 mg tablet tamsulosin (FLOMAX) 0.4 mg capsule
Current Illness:
Preexisting Conditions: Respiratory Chronic obstructive lung disease Pneumonia of right lower lobe due to infectious organism Malignant neoplasm of bronchus, unspecified laterality Acute respiratory failure with hypoxia Circulatory Arteriosclerosis of autologous vein coronary artery bypass graft Chronic ischemic heart disease Essential hypertension Digestive Viral gastritis Genitourinary Benign prostatic hyperplasia with urinary obstruction Musculoskeletal Generalized osteoarthritis Infected laceration Cellulitis of left upper extremity Endocrine/Metabolic Mixed hyperlipidemia Hematologic Chronic lymphocytic leukemia Platelets decreased Infectious/Inflammatory Septic shock COVID-19 virus infection Cellulitis Other Inguinal hernia without obstruction or gangrene Suspected urinary tract infection Elevated troponin Immunocompromised state
Allergies: NKA
Diagnostic Lab Data: 09/16/21 0022 Respiratory virus detection panel Collected: 09/15/21 2308 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time Ultrasound lower extremity venous right [3303463186] (Abnormal) Resulted: 09/17/21 0638 Order Status: Completed Updated: 09/17/21 0638 Narrative: PROCEDURE INFORMATION: Exam: US Duplex Right Lower Extremity Veins, Limited Exam date and time: 9/17/2021 4:56 AM Age: 85 years old Clinical indication: Swelling (edema) of limb; Lower extremity, right; Additional info: Eval for dvt TECHNIQUE: Imaging protocol: Real-time Duplex ultrasound of the Right Lower Extremity with 2-D gray scale, color Doppler flow and spectral waveform analysis with image documentation. Limited exam was focused on the right lower extremity veins. COMPARISON: CT ABD PEL W 4/5/2018 9:13 AM FINDINGS: Right deep veins: DVT involving the right posterior tibialis vein. The common femoral, femoral, proximal profunda femoral and popliteal veins are patent without thrombus. Normal Doppler waveforms. Normal compressibility and/or augmentation response. Right superficial veins: Unremarkable. Saphenofemoral junction is patent without thrombus. Soft tissues: Partially visualized enlarged right inguinal lymph node. IMPRESSION: DVT involving the right posterior tibialis vein. No other area of deep venous thrombosis. X-ray chest 1 view, Portable [3303267489] Resulted: 09/16/21 0730 Order Status: Completed Updated: 09/16/21 0730 Narrative: XR CHEST 1 VW PORT IMPRESSION: Mild interstitial pulmonary edema. END OF IMPRESSION: INDICATION: Suspected sepsis Suspected sepsis. TECHNIQUE: AP view of the chest. COMPARISON: None. FINDINGS: Pulmonary vascular congestion and basilar interstitial prominence. Median sternotomy wires and mediastinal clips are redemonstrated. Cervical posterior fusion hardware partially imaged. The heart is not enlarged. Costophrenic angles are clear. No pleural effusion or pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT chest without contrast [3303272248] (Abnormal) Resulted: 09/16/21 0304 Order Status: Completed Updated: 09/16/21 0304 Narrative: PROCEDURE INFORMATION: Exam: CT Chest Without Contrast; Diagnostic Exam date and time: 9/16/2021 2:03 AM Age: 85 years old Clinical indication: Shortness of breath; Patient HX: Covid; Additional info: SOB TECHNIQUE: Imaging protocol: Diagnostic computed tomography of the chest without contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. COMPARISON: DX XR CHEST 1 VW 9/16/2021 1:46 AM FINDINGS: Lungs: Unremarkable. No consolidation. No masses. Pleural spaces: Unremarkable. No pneumothorax. No pleural effusion. Heart: Stable CABG procedure. Aorta: Unremarkable. No aortic aneurysm. Great vessels off aortic arch: Calcification of the thoracic aorta and/or great vessels consistent with atherosclerotic vessel disease. Lymph nodes: Calcified left hilar nodes and/or mediastinal nodes and/or lung granulomas consistent with old granulomatous disease. Calcified left hilar nodes and/or mediastinal nodes and/or lung granulomas consistent with old granulomatous disease. Moderate right lower lobe pneumonia with possible mild right hilar adenopathy. Spleen: 20 cm large splenomegaly. Bones/joints: Unremarkable. No acute fracture. Soft tissues: Unremarkable. Other findings: Examination is limited by artifact from one or both arms by the patient''s side. IMPRESSION: 1. Stable CABG procedure. 2. Moderate right lower lobe pneumonia with possible mild right hilar adenopathy. 3. 20 cm large splenomegaly. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED X-ray chest 1 view, Portable [3303286895] (Abnormal) Resulted: 09/16/21 0258 Order Status: Completed Updated: 09/16/21 0258 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 9/16/2021 1:41 AM Age: 85 years old Clinical indication: Other vascular access device placement or adjustment; Other: Central line; Prior surgery; Surgery date: Post-operative (0-2 days); Additional info: Post central line TECHNIQUE: Imaging protocol: XR of the chest. Views: 1 view. COMPARISON: DX XR CHEST 1 VW 9/15/2021 10:48 PM FINDINGS: Tubes, catheters and devices: Right IJ line placement with tip over the region of the azygos vein. Lungs: Stable mild nonspecific bilateral pulmonary opacities. Pleural spaces: Unremarkable. No pleural effusion. No pneumothorax. Heart/Mediastinum: Unremarkable. No cardiomegaly. Vasculature: Calcification of the thoracic aorta and/or great vessels consistent with atherosclerotic vessel disease. Bones/joints: Stable postoperative metallic fixation of the cervical spine with or without metallic artifact. Stable sternotomy. IMPRESSION: Right IJ line placement with tip over the region of the azygos vein. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED CT head without contrast [3303286897] (Abnormal) Resulted: 09/16/21 0247 Order Status: Completed Updated: 09/16/21 0247 Narrative: PROCEDURE INFORMATION: Exam: CT Head Without Contrast Exam date and time: 9/16/2021 2:03 AM Age: 85 years old Clinical indication: Injury or trauma; Fall; Concussion/head injury; Without loss of consciousness; Injury date: Today TECHNIQUE: Imaging protocol: Computed tomography of the head without contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. COMPARISON: No relevant prior studies available. FINDINGS: Brain: No acute intracranial hemorrhage, mass effect or midline shift. Nonspecific white matter hypodensities without mass effect suggesting chronic ischemic changes. No evidence of obvious acute large vessel territorial infarct. Cerebral ventricles: Moderate to marked diffuse ventricular and sulcal prominence. Paranasal sinuses: Moderate bilateral paranasal sinus thickening/opacification. Mastoid air cells: No mastoid effusion. Vasculature: Intracranial atherosclerosis. Bones/joints: No acute fracture. Soft tissues: Unremarkable. IMPRESSION: 1. No acute intracranial hemorrhage or obvious acute large vessel territorial infarct 2. If there is concern for acute CVA, follow-up/further evaluation with MRI may provide additional information.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/15/2021 - 9/19/2021 (4 days) Last attending ? Treatment team Septic shock Principal problem Final Summary for Deceased Patient BRIEF OVERVIEW Admission Date: 9/15/2021 Discharge Date: 9/20/2021 Final Diagnosis Principal Problem: Septic shock Active Problems: Chronic lymphocytic leukemia Pneumonia of right lower lobe due to infectious organism Infected laceration COVID-19 virus infection Suspected urinary tract infection Elevated troponin Acute respiratory failure with hypoxia Immunocompromised state Cellulitis DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Acute pulmonary edema [J81.0] SIRS (systemic inflammatory response syndrome) [R65.10] Septic shock [A41.9, R65.21] Urinary tract infection without hematuria, site unspecified [N39.0] Congestive heart failure, unspecified HF chronicity, unspecified heart failure type [I50.9] COVID-19 [U07.1] Sepsis [A41.9] Pneumonia due to COVID-19 virus [U07.1, J12.82] Hospital Course: Please send details from H&P intensive care critical care note cardiology was done for neurologist as well as palliative care note In briefly 85-year-old male history of multiple comorbid condition including CLL with history colon cancer with hemicolectomy admitted with fever chills confusion found to have a right lower lobe pneumonia UTI sepsis septic shock left arm cellulitis. Complicated with septic shock secondary from pneumonia UTI with immunosuppressive state COVID-19 pneumonia patient progressively going downhill even with dopamine drip and continue having persistent hypotension including respiratory failure. Patient also found to have a right lower extremity DVT patient was initially started Lovenox changed to therapeutic since patient was continued required dopamine unable to discontinue dopamine because of persistent low blood pressure Case discussed with patient family palliative care was consulted and in spite of of all the antibiotic Maxipime and Zithromax and dexamethasone for COVID-19 patient progressively getting downhill palliative care was consulted patient family was involved with the case and since patient prognosis going downhill initially there may DO NOT RESUSCITATE and do not intubation and finally his 2 sons who is the power of attorney decided to comfort care only. Patient was discontinued dopamine as per policy and was only on oxygen comfort medication was started patient expired approximately September 19 approximately 1830. Because of that respiratory failure secondary from septic shock secondary from multifactorial including pneumonia UTI cellulitis COVID-19 and persistent hypotension in the setting of immunosuppressive patient with CLL colon cancer and lung mass. Operative Procedures Performed Treatments: As per hospital policy Procedures: ICU care including dopamine infusion Consults: Intensivist palliative care Pertinent Test Results: CT right lower lobe pneumonia right middle and lower lobe pneumonia POA * (Principal) Septic shock Yes Chronic lymphocytic leukemia Yes Acute nontraumatic kidney injury Yes Pneumonia of right lower lobe due to infectious organism Yes Infected laceration Yes Overview Signed 9/16/2021 7:31 AM Infected laceration left wrist with surrounding cellulitis COVID-19 virus infection Yes Suspected urinary tract infection Yes Elevated troponin Yes Overview Signed 9/16/2021 1:19 AM Probably due to demand Acute respiratory failure with hypoxia Yes Immunocompromised state Yes Overview Signed 9/16/2021 1:23 AM Due to Medical Problems Plan: 1. Sepsis with shock probably due to multifactorial, including right lower lobe pneumonia, infected laceration left wrist with cellulitis, suspected UTI. The patient will be started on vancomycin, cefepime, and Zithromax. Patient will be continued on Levophed which has been started in the emergency room. Respiratory treatment. Oxygen support. Continue with BiPAP. 2. Elevated troponin probably due to demand. Serial cardiac enzymes. If the troponi increase, we will get get an echocardiogram as well as start the patient on IV heparin drip. 3. Acute respiratory failure with hypoxia. The family does not want the patient to be intubated. The agreeable to using BiPAP. And they also agreeable to admitting the patient to the ICU and use ICU level medications to maintain the blood pressure. We will continue aggressive management with BiPAP. Respiratory treatment. 4. Acute kidney injury. Gentle IV hydration. If kidney function continues to discharge in the morning, consider nephrology consultation. VTE Prophylaxis: SCD Lovenox 40mg subcu daily DNR (Do Not Resuscitate) History of Present Illness Chief Complaint Patient presents with ? Fever ? Altered Mental Status Patient is an 85 y.o. male. Patient was brought to the emergency room and altered mental status and unable to give any history. According to the emergency room doctor, the patient was found in respiratory distress with O2 sat of 90% on room air but the patient was very tachypneic. Patient was also noted to be hypotensive with a blood pressure of 78/68. Temperature was 101.5. Patient has history of CLL. The white count in the emergency room was 94.6. Hemoglobin was 7.8. BUN was 41 with a serum creatinine of 2.53. Chest x-ray revealed bibasilar interstitial prominence. However, CT scan of the chest shows right lower lobe pneumonia. Assessment Review of Systems Unable to perform ROS: Mental status change


VAERS ID: 1768909 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-23
Onset:2021-09-08
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Angiogram cerebral abnormal, Anosmia, Anticoagulant therapy, Blood culture, Blood pressure decreased, COVID-19, Cardio-respiratory arrest, Cerebral endovascular aneurysm repair, Cerebral vasoconstriction, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Cough, Death, Deep vein thrombosis, Endotracheal intubation, General physical health deterioration, Hypophagia, Inappropriate schedule of product administration, Intracranial aneurysm, Intraventricular haemorrhage, Laboratory test, Lethargy, Mechanical ventilation, Mental status changes, Oropharyngeal pain, Pneumonia, Positive airway pressure therapy, Pulse absent, Respiratory tract congestion, Resuscitation, SARS-CoV-2 test positive, Sputum culture, Subarachnoid haemorrhage, Tachycardia, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-05
   Days after onset: 27
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Azelastine Nasal BID, Benzonatate 100 mg TID prn, Carvedilol 12.5 mg BID, Fluticasone Nasal QD, Glucosamine+Chondroitin QD, Hydroxyurea 500 mg BID, Losartan 100 mg QD, Sertraline 50 mg QD, Lisinopril 30 mg QD.
Current Illness:
Preexisting Conditions: Anxiety, Colon polyp, Dysrhythmia, essential thrmobocytosis, hyperlipidemia, hypertension, osteoarthritis, Polycythemia vera, H/O colon cancer.
Allergies: Milk
Diagnostic Lab Data: Positive COVID-19 test on 9/3/2021, 9/4/2021, and 9/28/2021
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/23/2021 and 2/23/2021. Patient presented to physician office on 9/3/2021 after developing COVID symptoms of cough, sore throat, congestion, loss of taste and smell 4-5 days prior, as well as reports that daughter had recently tested COVID positive. Patient received Casirivimab and Imdevimab on 9/6/2021. On 9/28/2021 patient presented to the ED for altered mental status. She was found to have a subarachnoid hemorrhage and was admitted with consultation to the Stroke team. She was intubated on 9/30/2021. BCx2, Pneumonia Panel, Sputum culture without any organism found. She underwent diagnostic cerebral angiogram and subsequent coiling of the anterior communicating artery aneurysm on 9/30/20201. On 10/01/2021 she was awake and following commands. After completing a spontaneous breathing trial she was successfully extubated. She was initially communicating, following commands, and A&O x 3. Over the night of 10/02/2021 she had increasing O2 demands and was placed on HFNC. She was tachycardic on 10/03/2021, she was more lethargic and would not swallow sips of water. A sepsis work up was initiated along with DVT studies do to history of Essential Thrombocytosis. She was found to have DVTs in BL upper extremities and R lower extremity. She required BIPAP to maintain ventilation. She was sent for CT/CTA of head which noted slightly increased intravenricular hemorrhage and vasospasm of the right ACA, left ACA, and left MCA. CT Chest was consistent with multifocal pneumonia. She was increased to subcutaneous heparin TID with ASA 81 mg. On 10/4/2021 she continued to regress. The morning of 10/05/2021 she would respond only to pain stimulus. She was evaluated again with CT with worsening vasospasm. Patient was intubated, after which her BP dropped Two attempts were made with push dose Phenylephrine to increase BP with out success. Her pulse was lost and compressions were started. Code Blue was called. Family was informed of the changes to her status and they decided to stop chest compressions and let her pass peacefully.


VAERS ID: 1770608 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Neoplasm malignant, Portal vein thrombosis
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), Embolic and thrombotic events, venous (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-27
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101275291

Write-up: cancer blown out of nowhere; portal vein thrombosis; strokes.; This is a spontaneous report from non-contactable healthcare professionals (one is a physician assistant). A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 2021 (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 reporter stated that just Tuesday, they shipped out three cardiomyopathies, and a blood clot. On 27Sep2021, the patient on the floor just died and the reporter just pronounced him a second ago. The patient got his shot and literally two weeks later, the patient ended up with cancer blown out of nowhere, a portal vein thrombosis like and got strokes in 2021. The patient died on 27Sep2021. 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: Based on the current limited available information, a possible contributory role of the suspect product BNT162B2 to the development of events cancer, portal vein thrombosis and strokes cannot be excluded. The case will be reassessed if additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: portal vein thrombosis; cancer blown out of nowhere; strokes.


VAERS ID: 1779036 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-06-01
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Deep vein thrombosis, Gait disturbance, Oedema peripheral, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XARELTO, LEVOTHYROXINE, ALBUTEROL, FLUVOXAMINE
Current Illness: TOBACCO ABUSE
Preexisting Conditions: CHRONIC OBSTRUCTIVE PULMONARY DISEASE; THYROID DISEASE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The decedent received her second Pfizer Covid vaccine on 04/07/2021. Some time later, she developed edema and in her legs with trouble walking. She presented to Hospital and diagnosed with bilateral deep venous thromboses in June 2021. A postmortem Covid-19 test is positive. She died on 08/22/2021.


VAERS ID: 1782334 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-13
Onset:2021-10-12
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaemia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest tube insertion, Computerised tomogram thorax normal, Culture, Death, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Faeces discoloured, Gastrointestinal haemorrhage, Haemofiltration, Hypotension, Intensive care, Mechanical ventilation, Oxygen saturation decreased, Pneumothorax, Renal impairment, Respiratory failure, SARS-CoV-2 test positive, Shock, Transfusion, Ultrasound Doppler abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-12
   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: Renal transplant x 3 on chronic immunosuppression, diabetes, hypertension, CAD
Allergies: Codeine, vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT. CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away.


VAERS ID: 1783015 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-25
Onset:2021-03-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Anaemia, COVID-19, COVID-19 pneumonia, Cerebral infarction, Death, Fasciotomy, Hypoxia, Intensive care, Mechanical ventilation, Multiple organ dysfunction syndrome, Peripheral artery thrombosis, Respiratory failure, SARS-CoV-2 test positive, Thrombectomy, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Interstitial lung disease (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   Days after onset: 29
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 29 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: chronic bronchitis
Preexisting Conditions: chronic bronchitis
Allergies: Unknown
Diagnostic Lab Data: 3/27/21 + PCR 4/21/21 + PCR
CDC Split Type:

Write-up: I am the epidemiologist reporting on behalf of 71-year-old male patient. The patient received two doses of the Pfizer vaccine on 3/3/21 and 3/25/21. The patient initially tested positive for COVID via a PCR test on 3/27/21 (two days after second dose) and again on 4/21/21. Patient was in ICU, on a Vent 4/2/21 until 4/25/21; Covid pneumonia, hypoxia, completed Remdesivir, patient had an arterial thrombosis LLE required a thrombectomy and fasciotomy on 4/4/21. Patient expired on 4/25/21 (one month after receiving second dose of Pfizer vaccine). Cause of death is listed as multiorgan failure secondary to COVID-19, ventilator dependent respiratory failure and ARDS. Other significant conditions contributing to death but not resulting in underlying cause are thrombocytopenia, anemia, right MCA infarct-subacute. I am reporting this to VAERS now because vaccination status was not considered at the time of the report.


VAERS ID: 1791285 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-16
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: 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 INC202101343365

Write-up: a 39 year old woman who got blood clots from the vaccine and died; This is a spontaneous report from a contactable consumer or other non hcp received from a Regulatory Authority. A 39-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID -19 VACCINE, formulation: solution for injection; Lot number and expiry date was not reported) via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On an unspecified date, patient who got blood clots from the vaccine and died. It was reported that patient had no history that got blood clots after receiving the Pfizer Covid vaccine and died. 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.; Reported Cause(s) of Death: a 39 year old woman who got blood clots from the vaccine and died


VAERS ID: 1791306 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-16
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: 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 INC202101352626

Write-up: Blood clot; This is a spontaneous report from a contactable consumer or other non hcp. This consumer (patient''s cousin) reported for a 37-year-old female patient (reporter''s cousin) who received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot/ number and Expiry date were unknown) via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunisation. Medical history and concomitant medications were not reported. On an unspecified date, the patient had blood clot and died on an unspecified date. Reporter states that he as a cousin of 37 years old (patient) that passed away after getting the vaccine due to a blood clot. States she was forced to get the vaccine to protect her kids, and that is not the only person her knew that has died. 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: Blood clot


VAERS ID: 1797997 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-14
Onset:2021-04-24
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Cerebral haemorrhage, Cerebral thrombosis, Death, Electrocardiogram, Electroencephalogram, General physical health deterioration, Laboratory test, Magnetic resonance imaging head, Neurological symptom, Vasogenic cerebral oedema
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), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-08
   Days after onset: 106
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: Brain MRI, CT angiogram, IR angiogram, EEG, EKG, labs April- July 2021.
CDC Split Type:

Write-up: Within 2 weeks of initial vaccine dose the patient developed new-onset acute neurologic symptoms resulting in a diagnosis of cerebral thrombosis with ICH and vasogenic edema. He underwent several outpatient, ER and inpatient evaluations (in the system, except for final hospitalization at Hospital); he continued to clinically deterioriate and died on August 8, 2021.


VAERS ID: 1804391 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-23
Onset:2021-10-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Back pain, Cardiac arrest, Cardiac massage, Catheterisation cardiac abnormal, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Coronary artery bypass, Cough, Death, Deep vein thrombosis, Dizziness, Dyspnoea, Fibrin D dimer increased, Intensive care, Myocardial injury, Oedema, Pain in extremity, Platelet count decreased, Pulmonary embolism, Resuscitation, Tenderness, Thrombectomy, Ultrasound Doppler abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-21
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: omeprazole, montelukast, methimazole, fluticasone, cyclosporine, cholecalciferol, cetrizine, nicotine, naproxen, albuterol, proventil
Current Illness: none that we are aware of
Preexisting Conditions: copd, scoliosis, arthritis, hyperthyroid, bradycardia, tachycardia, thyrotoxicosis
Allergies: gabapentin, quetiapine, acetaminophen, aspirin, caffeine, morphine, penicillin, pentazocine, propoxyphene
Diagnostic Lab Data: Dopplar US- right leg dVT ABD/PELVIS CT- Right heart strain Chest CTA- bilateral PEs DDIMER 10/20/21 13470 Platelets 10/20/21 237, 10/21/21 24
CDC Split Type:

Write-up: 10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain. She has had lightheaded episodes. Increasing leg pain after which she describes as possible fall. No head injury. No nausea no vomiting. No cough no hemoptysis. On arrival in the ED her room air pulse ox was between 85 and 88%. Pulse rate was 120s. Respiratory rate was in the 30 range. Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh. Mild edema neuro intact. Patient states she had her second Pfizer vaccine on Wednesday. Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21.


VAERS ID: 1810654 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-09-21
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101384220

Write-up: blood clot in the lungs; This is a spontaneous report from a contactable consumer. A 50-year-old female patient received bnt162b2 (BNT162B2), first single dose via an unspecified route of administration, administered in arm right on 10Sep2021 (Batch/Lot Number: FC3182) for covid-19 immunisation at age of 50-year-old. The patient was not pregnant at vaccination. Medical history included covid-19. No other vaccine received in four weeks. There were no concomitant medications. There was no covid tested post vaccination. The patient experienced blood clot in the lungs (death, life threatening) on 21Sep2021. No treatment received for the event. The patient died on 21Sep2021. It was unknown if an autopsy was performed. Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: blood clot in the lungs


VAERS ID: 1818171 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-23
Onset:2021-03-14
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6202 / 2 AR / -

Administered by: Private       Purchased by: ?
Symptoms: Adult failure to thrive, Agitation, Catatonia, Cerebrovascular accident, Death, Deep vein thrombosis, Ischaemic stroke
SMQs:, Neuroleptic malignant syndrome (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), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-21
   Days after onset: 98
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Quinapril Baby Asprin
Current Illness: Meningioma Brain Tumor (right temporal lobe)
Preexisting Conditions: High Blood Pressure (managed with medication), mild hearing loss
Allergies: none
Diagnostic Lab Data: Far too many, please contact hospitals where she was treated. March 16-April 12 April 12-May 3 May 3-May 28 May 28-June 21st
CDC Split Type:

Write-up: My mother had a minor stroke the week of March15th she went to the ER on March 16th but since an MRI was not performed they missed the stoke. 10 days later on Friday March 26th she had a larger Ischemic stroke and was hospitalized. She was moved to acute rehab when they found a blood clot in her leg on April 12th. By the end of the month she became non verbal and catatonic so she was moved back to Hospital on May 3rd, 2021. She was so agitated they couldn''t even give her a MRI to verify if she indeed she had another stroke. On May 28th she was moved to sub acute rehab and failed to thrive or respond to rehabilitation treatment. She died on June 21, 2021 just 4 months after her second Pfizer shot.


VAERS ID: 1823666 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-22
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135DA / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary thrombosis, Respiratory arrest, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: 2021-09-27
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101417077

Write-up: The patient had blood clots in arms that went to lung; The patient had blood clots in arms that went to lung; stopped breathing; This is a spontaneous report from a contactable consumer (patient''s wife). A 38-year-old male patient received bnt162b2, dose 2 via an unspecified route of administration, administered in left arm on 22Sep2021 (Lot Number: 30135DA) as dose 2, single at the age of 38 years old for COVID-19 immunization. Medical history included ongoing asthma diagnosed as a kid. There were no concomitant medications. Historic vaccine was bnt162b2 administered in right arm on 25Aug2021 (lot: FC3183) as dose 1, single at the age of 37 years old for COVID-19 Immunization. The patient worked and was on the do not vaccinate list. Someone mandated all employees to be vaccinated. The patient was on the do not vaccinate list but was denied by his workplace. The patient''s workplace approved others to not be vaccinated. The patient told the workplace receiving the vaccine was against his religious beliefs and the workplace denied the patient. Before the patient received the Pfizer Vaccine, the caller told her husband not to get the Pfizer Vaccine. The caller was also going to get the Pfizer Vaccine. Cause of death: The patient had blood clots in arms that went to lung. The blood clots formed a cluster when the paramedic was doing CPR, when the patient stopped breathing. The patient had fresh blood clots in the arms. Autopsy details available: The caller stated the autopsy details will be available in a few days. Someone told the caller, someone believed the patient''s death was a reaction to the Pfizer Vaccine. No any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient died on 27Sep2021. An autopsy was performed and results were not provided. The outcome of events was fatal.; Reported Cause(s) of Death: The patient had blood clots in arms that went to lung; The patient had blood clots in arms that went to lung; stopped breathing


VAERS ID: 1853315 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-07-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Ischaemic stroke, SARS-CoV-2 test, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 58 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Covid-19 test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101506590

Write-up: brain stroke and blood clot; brain stroke and blood clot; patient collapsed; This is a spontaneous report from a contactable consumer. A 79-years-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 31Jul2021 16:00 (Batch/Lot number was not reported) as single dose for covid-19 immunisation (Age at vaccination 79 years). The patient medical history was not reported. There were no concomitant medications. The patient experienced brain stroke and blood clot on 31Jul2021 22:00. patient collapsed (fall) (hospitalization, disability, life threatening) on 31Jul2021 22:00 with outcome of not recovered. The patient was hospitalized for brain stroke, blood clot and fall for 58 days. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on Sep2021 (Nasal Swab). Unknown therapeutic measures were taken as a result of brain stroke and blood clot and fall. The patient died on an unspecified date because of stroke and clots. It was not reported if an autopsy was performed. Course of the event. Patient received the 1st shot of Pfizer Covid-19 vaccine on July 31st 2021 at 4 PM and at 10 PM patient collapsed due to blood clot and due to Brain Stroke and Patient died few weeks later due to the damage from the blood clot and brain stroke. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Reported Cause(s) of Death: Ischaemic stroke; blood clot


VAERS ID: 1854668 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-01
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death, Fatigue, Myalgia, Thrombosis
SMQs:, Rhabdomyolysis/myopathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole gabapentin celecoxib nivolumab was last given on 9/03/2021
Current Illness: Squamous cell lung cancer, Hx of radiation therapy, on antineoplastic chemotherapy, Esophagitis due to radiation,
Preexisting Conditions: Recurrent respiratory papillomatosis, Tracheal papillomatosis
Allergies: Pineapple
Diagnostic Lab Data: There was no autopsy ordered
CDC Split Type:

Write-up: Was very tired and had sore muscles on September 09. Found September 10, 5:25 am dead. There were excessive amounts of blood along with large blood clots that appear to have come vaginally.


VAERS ID: 1873273 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-05-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Autopsy, Condition aggravated, Death, Dyspnoea, Intracardiac thrombus, Nausea, Pain in extremity, Pulmonary thrombosis, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-06-27
   Days after onset: 57
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Blood pressure medications.
Current Illness: Vertigo like symptoms couldn?t lay on one side of body. Nauseous.
Preexisting Conditions: Hypertension.
Allergies: No.
Diagnostic Lab Data: Autopsy said clots in lungs and heart.
CDC Split Type:

Write-up: Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath.


VAERS ID: 1885029 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-11
Onset:2021-11-13
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Adrenal mass, Alveolar lung disease, Arteriosclerosis, Ascites, Atelectasis, Blood culture negative, COVID-19, Central venous catheterisation, Chest X-ray, Colectomy, Colon cancer metastatic, Computerised tomogram abdomen abnormal, Condition aggravated, Death, Deep vein thrombosis, Dyspnoea, Echocardiogram, Echocardiogram normal, Ejection fraction normal, Endotracheal intubation, Explorative laparotomy, Gastrointestinal carcinoma, Hypotension, Inferior vena caval occlusion, Intensive care, Intestinal perforation, Large intestinal obstruction, Lung disorder, Lung opacity, Lymphadenopathy mediastinal, Mechanical ventilation, Metastases to liver, Metastases to lung, Metastases to pelvis, Metastases to peritoneum, Necrotic lymphadenopathy, Oedema, Osteolysis, Pleural effusion, Pneumonia, Pneumoperitoneum, Portal vein occlusion, Renal atrophy, Retroperitoneal neoplasm metastatic, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Septic shock, Shock, Small intestinal resection, Spinal compression fracture, Splenic infarction, Tenderness, Thrombosis, Vena cava filter insertion
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related conditions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal perforation (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (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: 2021-11-15
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: baclofen (LIORESAL) 10 MG tablet fentaNYL (DURAGESIC) 25 MCG/HR patch LORazepam (ATIVAN) 0.5 MG tablet mirtazapine (REMERON) 7.5 MG tablet naloxone (NARCAN) 4 mg/0.1 mL LIQD nasal liquid ondansetron (ZOFRAN) 8 MG tablet oxyCODONE 10 M
Current Illness:
Preexisting Conditions: Circulatory Acute deep vein thrombosis (DVT) of femoral vein of both lower extremities Digestive Colon cancer metastasized to multiple sites Therapeutic opioid induced constipation GI bleed Nausea Unspecified severe protein-calorie malnutrition Nervous Cancer related pain Other Encounter for consultation Secondary malignant neoplasm of bone Opioid use agreement exists Advanced care planning/counseling discussion Loss of appetite Shock Multiple comorbid conditions
Allergies: No Known Allergies
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time CV Echo Limited with Contrast Collected: 11/14/21 0808 Order Status: Completed Updated: 11/14/21 0900 Narrative: Heart Center LIMITED ECHOCARDIOGRAPHY REPORT Name: Patient Study Date: 11/14/2021 MRN: Patient Location: DOB: Patient Class: Inpatient Gender: Male Ordering Physician: MD Age: 62 yrs Height: 183 cm Performed By: RDCS Weight: 76 kg Resting HR: 113 BSA: 2.0 m2 Resting BP: 94/58 mmHg Reason For Study: Hypotension/shock, ., shock History/Symptoms: Covid 19, Shock,. Cancer Electronically signed by: MD on 11/14/2021 09:00 AM Interpretation Summary The left ventricular ejection fraction is 60%. The left ventricle is normal in size. No regional wall motion abnormalities noted. Right ventricular function cannot be assessed due to poor image quality. No pericardial effusion. There is no comparison study available. STUDY PERFORMED/QUALITY: A limited two-dimensional transthoracic echocardiogram was performed (2D). The technical quality of the exam was fair. Due to limited acoustic windows, Definity was administered. The study was done portable in the ICU. LEFT VENTRICLE: The left ventricle is normal in size. The left ventricular ejection fraction is 60%. The LV ejection fraction was determined utilizing visual estimation. No regional wall motion abnormalities noted. RIGHT VENTRICLE: Right ventricular function cannot be assessed due to poor image quality. PERICARDIUM/PLEURAL: No pericardial effusion. INFERIOR VENA CAVA: The inferior vena cava is normal in size (less than or equal to 2.1 cm) without assessment for collapse during patient sniff. Tricuspid Valve Great Vessels RAP systole: 3.0 mmHg IVC diam: 1.0 cm ______________________________________________________________________________ Reference Table: Normal Mild ModerateSevere Men LVEF $g 52% 41-51% 30-40% <30% Women LVEF $g 54% 41-53% 30-40% <30% Men LVIDd 4.2-5.8 5.9-6.3 6.4-6.8 $g6.8 Women LVIDd 3.8-5.2 5.3-5.6 5.7-6.1 $g6.1 LA Volume (ml/m^2) < 34 35-41 42-48 $g48 ______________________________________________________________________________ Electronically signed by: MD on 11/14/2021 09:00 AM All sources of data reside in the Cardiology PACS EJECTION FRACTION ECHO Collected: 11/14/21 0808 Order Status: Completed Updated: 11/14/21 0900 EJECTION FRACTION ECHO 60 % DR CHEST SINGLE VIEW Resulted: 11/14/21 0330 Order Status: Completed Updated: 11/14/21 0332 Narrative: EXAMINATION: Single View Chest EXAM DATE: 11/14/2021 2:50 AM TECHNIQUE: Portable upright AP INDICATION: Line and Endotracheal tube placement (Left IJ central line) COMPARISON: 11 hours earlier ENCOUNTER: Not applicable _________________________ FINDINGS: Interval intubation with the endotracheal tube tip 6 cm above the carina. New left internal jugular catheter with tip in the mid superior vena cava. Unchanged right-sided infusion port. New enteric tube coursing below the diaphragm and off the inferior aspect of the film with sidehole at the level of the gastroesophageal junction. Improved lung volumes. Normal heart size. Worsening bibasilar alveolar opacification. Persistent and probably unchanged right pleural effusion. No pneumothorax. _________________________ Impression: 1. Endotracheal tube 6 cm above the carina. 2. Enteric tube sidehole at the gastroesophageal junction. Recommend advancing several centimeters. 3. Appropriately positioned left internal jugular catheter. No pneumothorax. 4. Worsening bibasilar atelectasis and pneumonia with unchanged right pleural effusion. CT ABDOMEN AND PELVIS WITH IV CONTRAST Resulted: 11/13/21 1947 Order Status: Completed Updated: 11/13/21 1949 Narrative: EXAMINATION: CT Abdomen and Pelvis with IV Contrast EXAM DATE: 11/13/2021 5:54 PM TECHNIQUE: CT imaging of the abdomen and pelvis was performed with intravenous contrast. Coronal and sagittal images were reconstructed. CONTRAST: The amount and type of contrast are recorded in the medical record. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: Sepsis, sepsis, abd pain and tenderness COMPARISON: None ENCOUNTER: 10/21/2021 ____________________ FINDINGS: Lung Bases: Patchy airspace disease throughout the visualized lower lungs. Bilateral nodular opacity, may be infectious or neoplastic. Small-moderate bilateral pleural effusions. Partially necrotic mediastinal lymph nodes are partially imaged. Hepatobiliary: Innumerable hepatic metastases are not substantially changed from the recent comparison CT. Chronic occlusion of the left portal vein. The gallbladder is unremarkable. No biliary ductal dilatation. Pancreas: Normal. Spleen: The spleen is not enlarged. Heterogeneous enhancement of the spleen, may be perfusional or represent splenic infarcts. Adrenals: Left adrenal nodules have increased in size. The dominant left adrenal nodule measured 2 cm. The right adrenal gland is normal. Kidneys, Ureters, & Bladder: Small atrophic left kidney. No hydronephrosis. The urinary bladder is unremarkable. Gastrointestinal: Large irregular cecal mass is similar to prior examination. Mild diffuse small bowel distention without discrete transition point, may be on the basis of ileus. Reproductive Organs: Unremarkable. Lymphatic System: Multiple mesenteric, retroperitoneal, and pelvic nodal metastases, significant increased in size from the prior examination. Necrotic lymph node within the mid mesentery measures 3 x 1.7 cm. A right external iliac node measures 2.5 x 2 cm. Vasculature: The abdominal aorta is normal in caliber. Moderate atherosclerotic plaque. Interval placement of an IVC filter. Large thrombus within the IVC extending cephalad to the filter is also new from the comparison study. Stable left portal vein occlusion. Probable right femoral DVT. Peritoneum: Small scattered pneumoperitoneum is new from the prior examination and is likely related to perforation of the colonic mass (5:55). Moderate-large volume ascites, new/increased from prior examination. Several soft tissue tissue peritoneal metastases are again noted. Dominant peritoneal metastasis in the hepatorenal fossa is similar. Abdominal Wall & Musculoskeletal: Diffuse body wall edema. Stable severe T8 compression fracture. Lytic lesions involving the right sacrum and left ilium are similar and suspicious for osseous metastases. ____________________ Impression: 1. New small scattered pneumoperitoneum, likely related to perforation of the large right colonic mass. 2. Moderate-large volume ascites, substantially increased from prior. 3. Interval IVC filter placement. New large IVC thrombus which extends cephalad to the IVC filter. 4. Innumerable hepatic, left adrenal, and nodal metastases as above. Findings of peritoneal carcinomatosis and probable osseous metastases are also noted. 5. Extensive airspace disease in the visualized lower lungs. Bilateral nodular opacities are indeterminate but suspicious for metastatic disease. Mediastinal lymphadenopathy is partially imaged and also suspicious for metastatic disease. 6. New small bilateral pleural effusions. DR CHEST SINGLE VIEW Resulted: 11/13/21 1542 Order Status: Completed Updated: 11/13/21 1544 Narrative: EXAMINATION: Single View Chest EXAM DATE: 11/13/2021 2:56 PM TECHNIQUE: Single view chest INDICATION: Shortness of breath. COMPARISON: CT of the chest, abdomen, and pelvis 10/21/2021. ENCOUNTER: Not applicable _________________________ FINDINGS: Right chest port terminating in the lower SVC. The cardiomediastinal silhouette is unremarkable. There is a small right pleural effusion and there are patchy opacities at the lung bases. There is no pneumothorax. _________________________ Impression: Patchy opacities at the lung bases with a small right pleural effusion. Procedure Component Value Ref Range Date/Time Central Line Blood Culture (Normal) Collected: 11/13/21 1330 Order Status: Completed Specimen: Blood, Central Line Updated: 11/18/21 1502 Cult Blood Central Line No bacteria or yeast isolated Peripheral Blood Culture Collected: 11/13/21 1227 Order Status: Completed Specimen: Blood, Venous Updated: 11/18/21 1402 Cult Blood Peripheral No bacteria or yeast isolated COVID-19 PCR (Abnormal) Collected: 11/13/21 1508 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 11/13/21 1658 COVID-19 PCR Detected Abnormal
CDC Split Type:

Write-up: Patient expired 11/15/2021. HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9] Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure. Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021 Preliminary Cause of Death: Colon cancer metastasized to multiple sites


VAERS ID: 1885858 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-06
Onset:2021-11-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 - / JET

Administered by: Private       Purchased by: ?
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Death, Fall
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), Accidents and injuries (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-11-19
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: namenda nanoxen losartan
Current Illness: none
Preexisting Conditions: atherosclerosis asthma
Allergies: penicillin
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: she woke up normal, she went to her room for her prayers, and that''s when she fell out of her chair with a stroke. she was brought to the hospital immediately and was confirmed to have had blood clot in her brain. She was hospitalized from 11/09/2021 and passed away on11/19/2021.


VAERS ID: 1901194 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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: 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 INC202101630011

Write-up: Died of blood clots after being vaccinated; This is a spontaneous report from a non-contactable consumer. A 36-year-old male patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Batch/Lot number was not reported) on an unspecified date for covid-19 immunization. The patient died of blood clots after being vaccinated on an unspecified date, reported as Serious with serious criteria death, medically significant. The patient died on an unspecified date. It was not reported if an autopsy was performed. The outcome of the event Clot blood 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 of blood clots after being vaccinated


VAERS ID: 1910053 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-27
Onset:2021-11-22
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32020BD / 3 - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Hypotension, Intensive care, Oxygen saturation decreased, Pneumonia, Pulmonary thrombosis, Respiratory rate increased, Sepsis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-11-26
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin for Type 1 Diabetes
Current Illness:
Preexisting Conditions: Type 1 Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Double pneumonia with blood clots in lungs. Sepsis. Extremely low oxygen levels in blood. Extremely low blood pressure. Rapid breathing - over 60 per minute. 5-day ICU stay at Hospital. Death.


VAERS ID: 1916577 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-04-11
Onset:2021-10-06
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine increased, Blood sodium decreased, COVID-19, Death, Deep vein thrombosis, Intensive care, Leukocytosis, Malaise, SARS-CoV-2 test positive, Ultrasound Doppler normal
SMQs:, Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-28
   Days after onset: 22
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 90 mcg/puff inhaler Inhale 2 puffs into the lungs every 4 hours as needed . 10/1/21 amoxicillin (AMOXIL) 500 MG capsule Take 4 capsules by mouth once as needed (take 30-60 minutes once prior to dental procedures) for up to 1
Current Illness: ? Asthma Asthma/reactive airway disease ? Back pain Chronic musculoskeletal back pain syndrome ? Body aches 11/09/2016 ? Carpal tunnel syndrome Bilateral carpal tunnel syndrome ? Chronic kidney disease End-stage from IgA nephropathy. Hemodialysis ? Chronic prostatitis since 2005 ? Colon polyps Colon polyps. Last colonoscopy in 2007. Histology of previously excised ? Deceased-donor kidney transplant 8/3/2015 2/2/2 HLA mismatch, CPRA 0%, DCD donor, 47yoM deceased from head trauma, KD PI 68%, donor Cr 1.6, CMV D-/R+, EBV D+/R+ ? Delayed graft function of kidney transplant due to ATN requiring acute dialysis 8/3/2015 ? Depression Depression with anxiety ? GE reflux ? Hemorrhoids ? History of migraine headaches ? Hypertension ? Immunosuppression Thymoglobulin induction of total 6 mg/kg followed by Tac/MMF/pred ? Osteoarthritis Osteoarthritis, left shoulder ? Urine leak from transplanted ureter 8/10/2015 s/p nephrostomy tube and stent placement by IR on 8/10/2015
Preexisting Conditions: ? Asthma Asthma/reactive airway disease ? Back pain Chronic musculoskeletal back pain syndrome ? Body aches 11/09/2016 ? Carpal tunnel syndrome Bilateral carpal tunnel syndrome ? Chronic kidney disease End-stage from IgA nephropathy. Hemodialysis ? Chronic prostatitis since 2005 ? Colon polyps Colon polyps. Last colonoscopy in 2007. Histology of previously excised ? Deceased-donor kidney transplant 8/3/2015 2/2/2 HLA mismatch, CPRA 0%, DCD donor, 47yoM deceased from head trauma, KD PI 68%, donor Cr 1.6, CMV D-/R+, EBV D+/R+ ? Delayed graft function of kidney transplant due to ATN requiring acute dialysis 8/3/2015 ? Depression Depression with anxiety ? GE reflux ? Hemorrhoids ? History of migraine headaches ? Hypertension ? Immunosuppression Thymoglobulin induction of total 6 mg/kg followed by Tac/MMF/pred ? Osteoarthritis Osteoarthritis, left shoulder ? Urine leak from transplanted ureter 8/10/2015 s/p nephrostomy tube and stent placement by IR on 8/10/2015
Allergies: ? Nsaids Other (See Comments) Kidney Transplant ? Food Other (See Comments) Bananas, pecans, and walnuts can make throat scratchy. States he can eat the nuts prepared in foods but notices this if he eats these nuts by themselves. ? Lexapro [Escitalopram] Anxiety and Other (See Comments) Hypertention ? Latex Sensitivity Frequent contact: no known reaction ? Iodinated Diagnostic Agents Other (See Comments) CT contrast made him cold, chilly and nauseated
Diagnostic Lab Data: Ordered Test: SARS-CoV-2 RdRp Resp Ql NAA+probe (NOW Cov2 POC, Molecular) Ordered Test Codes: (LN LOINC)/(L LOCAL) Status: Final Accession Number: Specimen Source: Nasal Specimen Site: Specimen Collection Date/Time: 2021-09-27 16:53:00.0 Results: Resulted Test: SARS-C