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From the 11/19/2021 release of VAERS data:

Found 1,101 cases where Vaccine is COVID19 and Symptom is Arterial thrombosis or Arterial thrombosis limb or Axillary vein thrombosis or Blood fibrinogen increased or Complement factor C1 increased or Complement factor C3 increased or Complement factor C4 increased or Complement factor increased or Deep vein thrombosis or Platelet adhesiveness increased or Platelet dysfunction or Platelet function test abnormal or Pulmonary embolism or Secondary thrombocytosis or Thrombectomy or Thrombin-antithrombin III complex increased or Thrombin time abnormal or Thrombocytopenia or Thrombocytopenic purpura or Thrombolysis or Thrombophlebitis or Thrombosis or Thrombotic microangiopathy or Thrombotic stroke or Thrombotic thrombocytopenic purpura or Vena cava embolism or Vena cava thrombosis or Venous occlusion and Patient Died

Government Disclaimer on use of this data

Table

   
AgeVaccine/ManufacturerVaccine DoseYear of DeathCountPercent
< 3 YearsCOVID19 / PFIZER/BIONTECH2202110.09%
COVID19 / PFIZER/BIONTECH2total10.09%
COVID19 / PFIZER/BIONTECHtotal10.09%
total10.09%
12-17 YearsCOVID19 / PFIZER/BIONTECH1202110.09%
COVID19 / PFIZER/BIONTECH1total10.09%
COVID19 / PFIZER/BIONTECH2202110.09%
COVID19 / PFIZER/BIONTECH2total10.09%
COVID19 / PFIZER/BIONTECH3Unknown10.09%
COVID19 / PFIZER/BIONTECH3total10.09%
COVID19 / PFIZER/BIONTECHUNK202110.09%
COVID19 / PFIZER/BIONTECHUNKtotal10.09%
COVID19 / PFIZER/BIONTECHtotal40.36%
total40.36%
17-44 YearsCOVID19 / JANSSEN12021111%
COVID19 / JANSSEN1total111%
COVID19 / JANSSENUNK202150.45%
COVID19 / JANSSENUNKUnknown30.27%
COVID19 / JANSSENUNKtotal80.73%
COVID19 / JANSSENtotal191.73%
COVID19 / MODERNA1202190.82%
COVID19 / MODERNA1Unknown10.09%
COVID19 / MODERNA1total100.91%
COVID19 / MODERNA2202150.45%
COVID19 / MODERNA2total50.45%
COVID19 / MODERNAUNK202130.27%
COVID19 / MODERNAUNKUnknown20.18%
COVID19 / MODERNAUNKtotal50.45%
COVID19 / MODERNAtotal201.82%
COVID19 / PFIZER/BIONTECH12021111%
COVID19 / PFIZER/BIONTECH1Unknown10.09%
COVID19 / PFIZER/BIONTECH1total121.09%
COVID19 / PFIZER/BIONTECH22021161.45%
COVID19 / PFIZER/BIONTECH2Unknown10.09%
COVID19 / PFIZER/BIONTECH2total171.54%
COVID19 / PFIZER/BIONTECH3202110.09%
COVID19 / PFIZER/BIONTECH3total10.09%
COVID19 / PFIZER/BIONTECHUNK202130.27%
COVID19 / PFIZER/BIONTECHUNKUnknown10.09%
COVID19 / PFIZER/BIONTECHUNKtotal40.36%
COVID19 / PFIZER/BIONTECHtotal343.09%
COVID19 / UNKNOWN MANUFACTURER1202110.09%
COVID19 / UNKNOWN MANUFACTURER1total10.09%
COVID19 / UNKNOWN MANUFACTURERtotal10.09%
UNK / UNKNOWN MANUFACTURER1202110.09%
UNK / UNKNOWN MANUFACTURER1total10.09%
UNK / UNKNOWN MANUFACTURERUNK202110.09%
UNK / UNKNOWN MANUFACTURERUNKtotal10.09%
UNK / UNKNOWN MANUFACTURERtotal20.18%
total766.9%
44-65 YearsCOVID19 / JANSSEN12021181.63%
COVID19 / JANSSEN1total181.63%
COVID19 / JANSSENN/A202110.09%
COVID19 / JANSSENN/Atotal10.09%
COVID19 / JANSSENUNK2021111%
COVID19 / JANSSENUNKUnknown30.27%
COVID19 / JANSSENUNKtotal141.27%
COVID19 / JANSSENtotal333%
COVID19 / MODERNA12021262.36%
COVID19 / MODERNA1Unknown30.27%
COVID19 / MODERNA1total292.63%
COVID19 / MODERNA22021201.82%
COVID19 / MODERNA2total201.82%
COVID19 / MODERNA3202110.09%
COVID19 / MODERNA3total10.09%
COVID19 / MODERNAUNK2021171.54%
COVID19 / MODERNAUNKUnknown30.27%
COVID19 / MODERNAUNKtotal201.82%
COVID19 / MODERNAtotal706.36%
COVID19 / PFIZER/BIONTECH12021423.81%
COVID19 / PFIZER/BIONTECH1Unknown30.27%
COVID19 / PFIZER/BIONTECH1total454.09%
COVID19 / PFIZER/BIONTECH22021474.27%
COVID19 / PFIZER/BIONTECH2Unknown50.45%
COVID19 / PFIZER/BIONTECH2total524.72%
COVID19 / PFIZER/BIONTECH3202110.09%
COVID19 / PFIZER/BIONTECH3total10.09%
COVID19 / PFIZER/BIONTECHUNK2021312.82%
COVID19 / PFIZER/BIONTECHUNKtotal312.82%
COVID19 / PFIZER/BIONTECHtotal12911.72%
COVID19 / UNKNOWN MANUFACTURER1202110.09%
COVID19 / UNKNOWN MANUFACTURER1total10.09%
COVID19 / UNKNOWN MANUFACTURERtotal10.09%
UNK / UNKNOWN MANUFACTURER1202110.09%
UNK / UNKNOWN MANUFACTURER1total10.09%
UNK / UNKNOWN MANUFACTURER2202110.09%
UNK / UNKNOWN MANUFACTURER2total10.09%
UNK / UNKNOWN MANUFACTURERUNK202120.18%
UNK / UNKNOWN MANUFACTURERUNKUnknown20.18%
UNK / UNKNOWN MANUFACTURERUNKtotal40.36%
UNK / UNKNOWN MANUFACTURERtotal60.54%
total23921.71%
65-75 YearsCOVID19 / JANSSEN12021121.09%
COVID19 / JANSSEN1Unknown10.09%
COVID19 / JANSSEN1total131.18%
COVID19 / JANSSENN/A202110.09%
COVID19 / JANSSENN/Atotal10.09%
COVID19 / JANSSENUNK202170.64%
COVID19 / JANSSENUNKUnknown10.09%
COVID19 / JANSSENUNKtotal80.73%
COVID19 / JANSSENtotal222%
COVID19 / MODERNA1202010.09%
COVID19 / MODERNA12021312.82%
COVID19 / MODERNA1Unknown50.45%
COVID19 / MODERNA1total373.36%
COVID19 / MODERNA22021262.36%
COVID19 / MODERNA2Unknown20.18%
COVID19 / MODERNA2total282.54%
COVID19 / MODERNAUNK2021121.09%
COVID19 / MODERNAUNKtotal121.09%
COVID19 / MODERNAtotal776.99%
COVID19 / PFIZER/BIONTECH12021272.45%
COVID19 / PFIZER/BIONTECH1Unknown10.09%
COVID19 / PFIZER/BIONTECH1total282.54%
COVID19 / PFIZER/BIONTECH22021272.45%
COVID19 / PFIZER/BIONTECH2Unknown30.27%
COVID19 / PFIZER/BIONTECH2total302.72%
COVID19 / PFIZER/BIONTECH3202110.09%
COVID19 / PFIZER/BIONTECH3total10.09%
COVID19 / PFIZER/BIONTECHUNK2021514.63%
COVID19 / PFIZER/BIONTECHUNKUnknown50.45%
COVID19 / PFIZER/BIONTECHUNKtotal565.09%
COVID19 / PFIZER/BIONTECHtotal11510.45%
COVID19 / UNKNOWN MANUFACTURERUNK202120.18%
COVID19 / UNKNOWN MANUFACTURERUNKtotal20.18%
COVID19 / UNKNOWN MANUFACTURERtotal20.18%
total21619.62%
75+ YearsCOVID19 / JANSSEN12021100.91%
COVID19 / JANSSEN1Unknown10.09%
COVID19 / JANSSEN1total111%
COVID19 / JANSSENUNK202140.36%
COVID19 / JANSSENUNKtotal40.36%
COVID19 / JANSSENtotal151.36%
COVID19 / MODERNA12021575.18%
COVID19 / MODERNA1Unknown10.09%
COVID19 / MODERNA1total585.27%
COVID19 / MODERNA22021433.91%
COVID19 / MODERNA2total433.91%
COVID19 / MODERNA3202130.27%
COVID19 / MODERNA3total30.27%
COVID19 / MODERNA5202110.09%
COVID19 / MODERNA5total10.09%
COVID19 / MODERNAUNK202170.64%
COVID19 / MODERNAUNKtotal70.64%
COVID19 / MODERNAtotal11210.17%
COVID19 / PFIZER/BIONTECH12021635.72%
COVID19 / PFIZER/BIONTECH1Unknown50.45%
COVID19 / PFIZER/BIONTECH1total686.18%
COVID19 / PFIZER/BIONTECH22021807.27%
COVID19 / PFIZER/BIONTECH2Unknown60.54%
COVID19 / PFIZER/BIONTECH2total867.81%
COVID19 / PFIZER/BIONTECH3202130.27%
COVID19 / PFIZER/BIONTECH3total30.27%
COVID19 / PFIZER/BIONTECHUNK202010.09%
COVID19 / PFIZER/BIONTECHUNK2021312.82%
COVID19 / PFIZER/BIONTECHUNKUnknown10.09%
COVID19 / PFIZER/BIONTECHUNKtotal333%
COVID19 / PFIZER/BIONTECHtotal19017.26%
UNK / UNKNOWN MANUFACTURER2202110.09%
UNK / UNKNOWN MANUFACTURER2total10.09%
UNK / UNKNOWN MANUFACTURERUNK202110.09%
UNK / UNKNOWN MANUFACTURERUNKtotal10.09%
UNK / UNKNOWN MANUFACTURERtotal20.18%
total31928.97%
UnknownCOVID19 / JANSSENUNK2021272.45%
COVID19 / JANSSENUNKUnknown514.63%
COVID19 / JANSSENUNKtotal787.08%
COVID19 / JANSSENtotal787.08%
COVID19 / MODERNA1202140.36%
COVID19 / MODERNA1Unknown20.18%
COVID19 / MODERNA1total60.54%
COVID19 / MODERNAUNK202110.09%
COVID19 / MODERNAUNKUnknown30.27%
COVID19 / MODERNAUNKtotal40.36%
COVID19 / MODERNAtotal100.91%
COVID19 / PFIZER/BIONTECH1202111910.81%
COVID19 / PFIZER/BIONTECH1Unknown242.18%
COVID19 / PFIZER/BIONTECH1total14312.99%
COVID19 / PFIZER/BIONTECH2202113111.9%
COVID19 / PFIZER/BIONTECH2Unknown403.63%
COVID19 / PFIZER/BIONTECH2total17115.53%
COVID19 / PFIZER/BIONTECH3202140.36%
COVID19 / PFIZER/BIONTECH3Unknown10.09%
COVID19 / PFIZER/BIONTECH3total50.45%
COVID19 / PFIZER/BIONTECHUNK202010.09%
COVID19 / PFIZER/BIONTECHUNK2021706.36%
COVID19 / PFIZER/BIONTECHUNKUnknown444%
COVID19 / PFIZER/BIONTECHUNKtotal11510.45%
COVID19 / PFIZER/BIONTECHtotal43439.42%
COVID19 / UNKNOWN MANUFACTURER1Unknown10.09%
COVID19 / UNKNOWN MANUFACTURER1total10.09%
COVID19 / UNKNOWN MANUFACTURER2Unknown10.09%
COVID19 / UNKNOWN MANUFACTURER2total10.09%
COVID19 / UNKNOWN MANUFACTURERtotal20.18%
FLU4 / GLAXOSMITHKLINE BIOLOGICALSUNK202140.36%
FLU4 / GLAXOSMITHKLINE BIOLOGICALSUNKtotal40.36%
FLU4 / GLAXOSMITHKLINE BIOLOGICALStotal40.36%
UNK / UNKNOWN MANUFACTURER1202130.27%
UNK / UNKNOWN MANUFACTURER1total30.27%
UNK / UNKNOWN MANUFACTURER2202120.18%
UNK / UNKNOWN MANUFACTURER2Unknown20.18%
UNK / UNKNOWN MANUFACTURER2total40.36%
UNK / UNKNOWN MANUFACTURERUNK202170.64%
UNK / UNKNOWN MANUFACTURERUNKUnknown20.18%
UNK / UNKNOWN MANUFACTURERUNKtotal90.82%
UNK / UNKNOWN MANUFACTURERtotal161.45%
total54449.41%
TOTAL† 1,399† 127.07%
† Because some cases have multiple vaccinations and symptoms, a single case can account for multiple entries in this table. This is the reason why the Total Count is greater than 1101 (the number of cases found), and the Total Percentage is greater than 100.



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: 979773 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-30
Onset:2021-01-16
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none as far as i know
Current Illness: none per care giver
Preexisting Conditions: none that was reported
Allergies: none reported
Diagnostic Lab Data: none that i know of
CDC Split Type:

Write-up: Not sure if it has to do with the COVID vaccine but her caregiver reported to me today (1/27/20201) that she passed away on 01/16/2021 from a pulmonary embolism that was 18 days after vaccine


VAERS ID: 981912 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-23
Onset:2021-01-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Cardiac arrest, Chest pain, Cold sweat, Death, Endotracheal intubation, Hypotension, Laboratory test, Pallor, Pulmonary embolism
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (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), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-27
   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: albuterol, fluticasone nasal spray, hydrochlorothiazide, losartan
Current Illness:
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: 1/27 in the ED patient underwent a CTA chest to reveal PE, basic labs, alteplase 100 mg, amiodarone 150 mg followed by infusion, was intubated with rocuronium, and placed on a norepinephrine drip.
CDC Split Type:

Write-up: Patient presented to the Emergency Department complaining of chest pain, pale, cool diaphoretic, and hypotensive. The patient was discovered to have a large saddle pulmonary embolism, went into cardiac arrest and expired. Of note, the patient received her second Moderna COVID vaccine on 1/23, which would place her first one approximately 12/25 if she received them at the appropriate interval. This information is from the patient''s daughter and the ED record, the information is not available in CAIR. Per the daughter, the patient started feeling ill on 1/21, improved on 1/25, and then acutely worsened on 1/27, resulting in the ED visit.


VAERS ID: 997677 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-01
Onset:2021-02-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Cerebrovascular accident, Coma scale abnormal, Death, General physical health deterioration, Heart rate increased, Loss of consciousness, Posturing, Pulmonary embolism
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), 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), Dystonia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-03
   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: Losartan, dilTIAZem, Omeprazole, Ipratropium-Albuterol Solution, Perforomist Nebulization Solution, Furosemide, Budesonide Suspension, Levothyroxine , PARoxetine, Melatonin, Ibuprofen, Aspirin, Cholecalciferol, Docusate Sodium Capsule, ARIP
Current Illness:
Preexisting Conditions: PULMONARY FIBROSIS, CHRONIC RESPIRATORY FAILURE WITH HYPOXIA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, HYPOTHYROIDISM, HYPERTENSION, IRON DEFICIENCY ANEMIAS
Allergies: Amlodipine, Ciprofloxacin, Citalopram, Codeine, Penicillin, traMADol, Spiriva Respimat, Sulfa Antibiotics
Diagnostic Lab Data: Family declined treatment or diagnostic testing. Dr signed comfort orders, verbalized probable PE or stroke
CDC Split Type:

Write-up: Rapid decline in health status, Elevated BP&P, posturing, loss of consciousness, Glasgow coma Scale 4 starting 2/1/2021, Deceased 2/3/21


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: 1002636 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-28
Onset:2021-01-17
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Angiogram cerebral abnormal, Aphasia, Cerebral artery occlusion, Computerised tomogram abnormal, Computerised tomogram head, Death, Fall, Movement disorder, NIH stroke scale score increased, Nervous system disorder, Thrombectomy
SMQs:, Ischaemic 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), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-01-23
   Days after onset: 6
Permanent Disability? Yes
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: ASA 81 mg, allopurinol, potassium chloride, furosemide, diltiazem, metoprolol, tiotropium, albuterol, diclofenac gel topical
Current Illness: None - had exposure to COVID19 + case on 12/18/2020 but tested negative.
Preexisting Conditions: CHF, HTN, hyperlipidemia, atrial fibrillation, COPD (O2 dependent) , CKD Stage 4, type 2 diabetes (diet controlled).
Allergies: Oxycodone, Percodan, atenolol, PCN VK
Diagnostic Lab Data: CT 1/17/21 (no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory) and CT Angiogram on 1/17/21 ( distal L M1/M2 occulsion).
CDC Split Type:

Write-up: On 1/17/2021 patient woke and began her day as usual, was found down by family member 1 hour later conscious but unable to speak and unable to move her R side. She was admitted to the hospital - Initial NIHSS was 26 and CT imaging showed no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory (TPA not recommended). CTA did show distal L M1/M2 occulsion and she was transferred to larger facility for thrombectomy. Unfortunately the patient had persistent severe neurological deficits after thrombectomy. Was discharged home on hospice care and expired on 1/23/21.


VAERS ID: 1006994 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-01-22
Onset:2021-01-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Condition aggravated, Death, Thrombotic thrombocytopenic purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, arterial (narrow), Renovascular disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-26
   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: atorvastatin Excedrin Extra Strength gabapentin lansoprazole Lantus Solostar U-100 Insulin lisinopril Ozempic phenazopyridine Prelief Vitamin B-12 vitamin D3-vitamin K2 (MK4) zolpidem
Current Illness:
Preexisting Conditions: Diabetes Hyperlipidemia
Allergies: penicillin and sulfa
Diagnostic Lab Data: CT scans plus transport to an out of state hospital. No records from that hospital to report.
CDC Split Type:

Write-up: Patient had one occurrence of thrombotic thrombocytopenic purpura in 1996 for which she had plasma exchange therapy in 1996. No other occurrence since 1996 until she received her first dose of the Pfizer covid vaccine.


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: 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: 1028101 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-01-22
Onset:2021-01-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood gases abnormal, Cardio-respiratory arrest, Death, Electrocardiogram abnormal, Hypoxia, Metabolic acidosis, Metabolic function test normal, Myocardial ischaemia, Pain in extremity, Peripheral swelling, Pulmonary embolism, Pulseless electrical activity, Resuscitation, SARS-CoV-2 test negative, Syncope, Troponin normal
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (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), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol 400mg Daily
Current Illness: Hyperuricemia Renal stone
Preexisting Conditions: Hyperuricemia Renal Stones
Allergies: Shellfish
Diagnostic Lab Data: ABG'' Met acidosis hypoxia EKG; Inf ischemia BMP; normal Troponin; Normal Covi 19 ;Neg
CDC Split Type:

Write-up: Pt develops left leg pain The day after vaccination in AM subsequently drove approximately 150 miles On his way back stopped at his brothers place for lunch. He then collapsed coning down the steps, EMS started CPR. took him to ER Resuscitated briefly but went into CardioPulm Arrest again and PEA Resucitaion for aprox 1 hour but was unsuccessful. Noted to have Left leg more swollen than Right by 3 to 4 CM presumed to have died from massive Pulmonary embolism and inferior wall myocardial ischemia


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