National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/7/2022 release of VAERS data:

Found 20 cases where Vaccine is COVID19 and Symptom is Road traffic accident and Patient Died

Government Disclaimer on use of this data

Table

   
Event OutcomeCountPercent
Death20100%
Office Visit210%
Emergency Doctor/Room420%
Hospitalized315%
TOTAL† 29† 145%
† 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 20 (the number of cases found), and the Total Percentage is greater than 100.



Case Details (Sorted by State)

VAERS ID: 1118956 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-11
Onset:2021-02-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Death, No adverse event, Road traffic accident, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   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: Patient passed away unrelated to COVID vaccine Narrative: The patient has COPD and congestive heart failure. Patient received first dose of Moderna vaccine on 1/11/2021 and no adverse reaction was reported. Patient''s son reported patient had a minor car accident and was taken to ER where he was tested positive for COVID pneumonia and he passed away in his sleep on the morning of 2/4/2021. Patient''s son stated due to his COPD, he was not able to survive the COVID pneumonia. No indication that death was related to COVID 19 vaccination.


VAERS ID: 1028476 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-01-21
Onset:2021-01-22
   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 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic shock, Cardiac failure, Death, Dyspnoea, Intensive care, Loss of consciousness, Multiple organ dysfunction syndrome, Myocardial infarction, Road traffic accident
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (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 (narrow), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-28
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Don''t have a list
Current Illness:
Preexisting Conditions: A fib, type 2 diabetes, obesity
Allergies:
Diagnostic Lab Data: You will have to contact the Hospital.
CDC Split Type:

Write-up: She started having breathing problems/heart attack appearance. on 1/22/21 and went to the ER. Upon admittance was told it was an anaphylactic shock from the Covid shot. They kept her in ICU and released her 1/23/21. At 12:45 am on 1/24/21 she passed out and we called the ambulance. Hospital admitted her and worked through multiple organ failure issues and thought her numbers were under control. She was released on 1/27/21 and was driving on 1/28/21 around 4:15 pm and appears to have had heart failure and had a wreck. She passed away that day.


VAERS ID: 1180840 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 3.5 hours after receiving the vaccine, the patient was killed in a head-on collision. The patient was driving when her vehicle crossed the centerline and struck a second vehicle head on. It is unknown if the COVID19 vaccine contributed to the collision and death.


VAERS ID: 1065213 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-04
Onset:2021-02-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9788 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-06
   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: ZANIDIP
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021203349

Write-up: Accident automobile; This is a spontaneous report from a contactable pharmacist received from the Medicines Agency (MA) regulatory authority-WEB FR-AFSSAPS-MA20210521. A 79-year-old male patient received the first dose of bnt162b2 (COMIRNATY) (Lot # EK9788), intramuscular at single dose in the left arm on 04Feb2021 for covid-19 immunisation. Medical history included high blood pressure. Concomitant medication included lercanidipine hydrochloride (ZANIDIP) at 10 mg daily for hypertension arterial. On 06Feb2021, 48 hours after vaccination, the patient experienced accident automobile with fatal outcome. Unsuccessful resuscitation, cause of death not identified (Malaise?). The patient died on 06Feb2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Accident automobile


VAERS ID: 1165250 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-12
Onset:2021-03-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET1831 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Haematoma, Road traffic accident
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-23
   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: CONCOR; TORASEMID; THROMBO ASS; OLEOVIT D3; SPIRONO; METFORMIN; ATORVASTATIN; ACEMIN [ACECLOFENAC]
Current Illness: Heart insufficiency (Heart Failure with Reduced Ejection Fraction - Dilated Cardiomyopathy); Pacemaker insertion (cardiac) (CRT Implantation); Type 2 diabetes mellitus (diabetes mellitus II)
Preexisting Conditions: Comments: DM II, HFrEF - dil. CM?
Allergies:
Diagnostic Lab Data:
CDC Split Type: ATPFIZER INC2021342441

Write-up: Traffic accident without external fault: Resuscitation (NEF); multiple hematomas (before accident): hematomas right and left upper arm, upper abdomen; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB AT-BASGAGES-2021-19144. A 62-year-old male patient received BNT162B2 (COMIRNATY), first dose via an unspecified route of administration on 12Mar2021 (batch/lot number: ET1831) as a single dose for COVID-19 immunisation. Medical history included ongoing heart insufficiency (heart failure with reduced ejection fraction - dilated cardiomyopathy), pacemaker insertion (cardiac) from 11Mar2021 and ongoing (CRT implantation), and ongoing type 2 diabetes mellitus (diabetes mellitus II). Concomitant medications included bisoprolol fumarate (CONCOR); torasemide (TORASEMID); acetylsalicylic acid (THROMBO ASS); colecalciferol (OLEOVIT D3); spironolactone (SPIRONO); metformin; atorvastatin; aceclofenac (ACEMIN); all taken for unspecified indications, start and stop date were not reported. The patient experienced death on 23Mar2021, traffic accident without external fault: resuscitation (NEF) on 23Mar2021 08:40 (as reported), multiple hematomas (before accident): hematomas right and left upper arm, upper abdomen on 23Mar2021. It was also reported that on 23Mar2021 at 8:30 a.m. (as reported) emergency call due to a traffic accident (no fault of third party) - resuscitation (NEF) - death. Multiple hematomas (BEFORE accident). Hematomas right and left upper arm, upper abdomen; possibly due to the mechanism of HIT and thrombosis discussed in connection with COVID-19 vaccinations. The outcome was fatal for death and road traffic accident, and unknown for hematoma. The patient died on 23Mar2021. An autopsy was not performed. A medical autopsy was refused by the BH. There was a causal connection between the vaccination on 12Mar2021 and the traffic accident on 23Mar2021. The traffic accident was caused by an atypical agreement from the road, most likely through loss of consciousness. The patient was found to have multiple hematomas in the morning on the same day. The patient was vaccinated with BNT162B2 shortly before. Relatedness of drug to events as per reporter was possible. No follow-up attempts are needed. No further information is expected.; Reported Cause(s) of Death: Traffic accident without external fault: Resuscitation (NEF)


VAERS ID: 1477239 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-06-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0779 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Head injury, Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-21
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPPFIZER INC2021812436

Write-up: Automobile accident; Crashed head-on into a wall; This is a spontaneous report from a contactable physician received via regulatory authority. The patient was an 81-year-old male. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. It was unknown whether the patient received any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. It was unknown whether the patient had medical history or allergies to medications, food, or other products. On 01Jun2021 (the day of vaccination) (at the age of 81 years), the patient received the first dose of BNT162B2 (COMIRNATY Solution for injection; Lot Number: EY0779, Expiration Date: 31Aug2021), intramuscular in left arm, as single dose, for COVID-19 immunization. It was unknown whether the patient has been tested for COVID-19 since the vaccination. On 21Jun2021 at 17:00 (20 days after the vaccination), the patient experienced automobile accident. The course of the event was as follows. On 21Jun2021, the patient died of automobile accident. After a scrape automobile accident, the patient probably felt panicked, hit the gas instead of the brake, and crashed head-on into a wall. The patient did not have seat belt on. It was unknown whether the patient received treatment. The outcome of the events was fatal. The patient died on 21Jun2021. After autopsy, this information was received from the patient''s family. The reporting physician classified the events as serious (death).; Sender''s Comments: Based on the information currently available, the reported events are due to an accident, but not related to 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: Crashed head-on into a wall; Automobile accident


VAERS ID: 1507258 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Illness, Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITJNJFOC20210754119

Write-up: SUDDEN ILLNESS; MOTOR VEHICLE ACCIDENT; This spontaneous report received from a patient via a company representative concerned a 33 year old male of unknown race and ethnic origin. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown expiry Unknown) frequency 1 total dose, for prophylactic vaccination on an unspecified date around one and half month ago prior reporting. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 24-JUL-2021 the patient died while driving a bus for a sudden illness. The driver had been vaccinated, causing an accident that resulted in the injury of several people and the death of the driver himself. Post-mortem examinations were underway to determine whether the accident occurred due to the driver being sick or for other reasons. Autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0: 20210754119--Sudden illness, motor vehicle accident. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: SUDDEN ILLNESS; MOTOR VEHICLE ACCIDENT


VAERS ID: 1931100 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-10-21
Onset:2021-11-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1H055A-CDC / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Road traffic accident
SMQs:, Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-03
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: TWPFIZER INC202101709675

Write-up: car accident; CHEST PAIN; This is a spontaneous report received from non-contactable Healthcare professional from License Party and Regulatory Authority. Regulatory number: TW-TFDA-TVS-1100012311. Other Case identifier(s): TW-Fosun-2021FOS005575. This is a spontaneous report received from a non-contactable HCP received via Regulatory Authority. The regulatory authority report number is TW-TFDA-TVS-1100012311. A 58-year-old male patient started to receive a dose of Tozinameran (COMIRNATY) (batch number: 1H055A-CDC) on 21-Oct-2021 via intramuscular at unknown dose with unspecified dosing frequency for COVID-19 immunization. Medical history, concomitant medications and past product were not reported. The patient experienced chest pain on 03-Nov-2021. On 21-Oct-2021, patient received a dose of vaccination. On 03-Nov-2021, the patient experienced chest pain. The patient had a car accident on the way to visit the doctor. It was reported that "119 people said that the patient came to the scene". The patient has autonomous breathing heartbeat, was given cardiopulmonary resuscitation (CPR). Chest pain met the seriousness criterion of results in Death. The action taken for Tozinameran (COMIRNATY) regarding the chest pain was not applicable. At the time of the report, the outcome of the event was fatal. Initial report was received on 24-Nov-2021. Follow-up closed, no further information is possible. BioNTech SE Comment: The medical review comments of PV Department on the report of chest pain is as follows: The seriousness of chest pain is: result in death. Chest pain is not a common adverse event in the package insert of COMIRNATY, so its expectedness is: unexpected. Given the limited information available to date, it is difficult to exclude a causal relationship, and the relationship between chest pain and COMIRNATY is considered as possible. BNT162B2 (COMIRNATY) is under agreement with BioNTech SE No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: CHEST PAIN


VAERS ID: 1987958 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-11-17
Onset:2021-11-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Altered state of consciousness, Chest pain, Road traffic accident
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gout; Hyperlipemia; Obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type: TWPFIZER INC202101855517

Write-up: AWARENESS CHANGE; CHEST PAIN; CAR ACCIDENT; This is a spontaneous report received from non-contactable reporter(s) (Other HCP) from License Party and Regulatory Authority. Regulatory number: TW-TFDA-TVS-1100014722. Other Case identifier(s): TW-Fosun-2021FOS007035. This is a spontaneous report received from a non-contactable HCP received via the regulatory authority. The regulatory authority report number is TW-TFDA-TVS-1100014722. A 51-year-old male (body weight: 130 kg) patient started to receive 2nd dose of Tozinameran (COMIRNATY) (batch number was not reported) on 17-Nov-2021 via unknown route at unknown dose with unspecified dosing frequency for COVID-19 immunization. The 1st dose of vaccination was received on an unknown date. Medical history included gout, obese, pulled and high blood lipid. Concomitant medications and past product were not reported. The patient experienced awareness change, chest pain and car accident on 19-Nov-2021. On 19-Nov-2021, the patient experienced chest pain (awareness change was also reported to have occurred on the same day) when driving, and resulting in a car accident. The patient was sent to hospital for medical treatment and death. On the same day, judicial anatomy was performed. Preliminary research: 1. left ventricular hypertrophy. 2. left front deprivation coronary tube cavity was formed, stenosis. Awareness change, chest pain and car accident met the seriousness criterion of Results in Death. The action taken for Tozinameran (COMIRNATY) regarding the event was not applicable. At the time of the report, the outcome of the event was fatal. The patient died on 19-Nov-2021. An autopsy was performed on 19-Nov-2021, and the reported cause of death included "left ventricular hypertrophy" and "left front deprivation coronary tube cavity was formed, stenosis". According to the description, the awareness change, chest pain and car accident were also considered to be the cause of death. Initial report was received on 15-Dec-2021. Follow-up closed, no further information is possible. Sender comments: The medical review comments of Pharmacovigilance (PV) Department on the report of awareness change, chest pain and car accident is as follows: The seriousness of awareness change, chest pain and car accident is: results in death. Awareness change, chest pain and car accident are not common adverse events in the package insert of COMIRNATY, so the expectedness is: unexpected. Given the limited information available to date, it is difficult to exclude a causal relationship, and the relationships between awareness change, chest pain and car accident and COMIRNATY are considered as possible. Causality assessment for the reactions Altered state of consciousness; Chest pain; Accident automobile was possible per Primary reporter and per Company. Bnt162b2 (COMIRNATY) is under agreement. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: AWARENESS CHANGE; CHEST PAIN; CAR ACCIDENT; LEFT VENTRICULAR HYPERTROPHY; LEFT FRONT DEPRIVATION CORONARY TUBE CAVITY WAS FORMED, STENOSIS


VAERS ID: 1924075 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-03
Onset:2021-08-22
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Brain injury, COVID-19, Cardiac arrest, Chest pain, Death, Device inappropriate shock delivery, Hypoxia, Intensive care, Nervous system disorder, Respiratory failure, Road traffic accident, SARS-CoV-2 test positive, Stent placement, Troponin increased, Vaccine breakthrough infection, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-03
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 2 puffs Q6h PRN amiodarone 400 mg PO QD aspirin 81 mg PO QD atorvastatin 20 mg PO QD carvedilol 12.5 mg PO BID vitamin D 1000 units PO QD clopidogrel 75 mg PO QD insulin glargine 10 units SQ HS insulin lispro 5 units SQ AC nitrogl
Current Illness: CAD HTN CHF h/o stents h/o angioplasty h/o CABG OSA DM T2
Preexisting Conditions: CAD HTN CHF h/o stents h/o angioplasty h/o CABG OSA DM T2
Allergies: codeine - hives tramadol - unknown
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: COVID BREAKTHROUGH Pfizer Dose 1 2/10/21 (EN6201) Pfizer Dose 2 3/3/21 (EN6199) COVID Positive 8/22/21 8/22/21: Patient is a 75 year old male with past history of coronary disease status post CABG, ischemic cardiomyopathy status post AICD placement, diabetes mellitus, hypertension, and hyperlipidemia who was admitted after having multiple shocks from his AICD. History is obtained from chart review as well as discussion with the patient and the ED provider. Patient does have a history of a coronary artery bypass in 1990. He has a history of multiple stents and appears his last stents were placed approximately 2 years ago at an outside hospital. Last stents placed at this hospital were an 2016. He does still take aspirin and Plavix daily. Patient states that he was driving yesterday morning when he rear-ended a vehicle at approximately 12:30 a.m.. He states that the airbags did deploy a and that he had significant pain on his chest from the seatbelt. He denies losing consciousness prior to the episode. He did not seek out medical treatment at that time and went home. He went to sleep and then woke up to after being shocked by his defibrillator. He thought he was shocked about 3 times however on interrogation he received a total of 10 shocks and a 5 minutes period. His chest is quite sore and overall just feels weak from the defibrillator episodes. Not having any current shortness of breath, fevers, chills, nausea, vomiting, abdominal pain. Transferred to this hospital after being started on amiodarone infusion. Troponin slightly elevated. 9/3/21: Patient was admitted and Cardiology was consulted given AICD firing for ventricular fibrillation. Was recommended that he undergo an ischemic workup however he is COVID-19 test returned positive. He was started on remdesivir as well as Decadron. He did have some mild hypoxemia. He was placed on a heparin infusion as well as amiodarone infusion. He was switched to oral amiodarone and underwent coronary angiogram on 8/27. He had a drug-eluting stent placed to the saphenous vein graft to the obtuse marginal branch. Patient was going to be discharged the following day however did develop some hypoxemia. Hypoxemia worsened and on 08/29 he under went a PA cardiac arrest. He did have some ventricular fibrillation and ROSC was obtained. He was transferred to the ICU. Pulmonary was consulted and he underwent hypothermia protocol. His neurologic status was quite poor however sedation was not able to be weaned given his significant hypoxemia related to COVID-19. He was started on broad-spectrum antibiotics. Family ultimately decided on comfort measures given his poor prognosis from a heart standpoint, respiratory failure, and suspected anoxic brain injury. He was palliatively extubated and passed away at 1:02 p.m. on 09/03/2021.


VAERS ID: 1868510 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-17
Onset:2021-09-22
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 UN / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOW / 2 UN / UN

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Asthenia, COVID-19, Confusional state, Death, Depressed level of consciousness, Feeling abnormal, Hypertension, Hypoxia, Impaired driving ability, Malaise, Moaning, Oxygen saturation decreased, Respiratory tract congestion, Road traffic accident, SARS-CoV-2 test positive, Speech disorder, Walking aid user
SMQs:, Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospice Nurse'' Note on 9/21/2021: "This nurse received a phone call from a very close friend of hers reporting that her husband?s uncle Has Covid and took a very bad turn this afternoon. Patient does not want to go to the hospital and does not want to be on any machines. He is a 98 year-old. He is a bachelor and has been living alone since his sister died that he used to live with. He has been alert and oriented and able to live alone with someone just checking in on him. Several months ago his nephew who is his caretaker moved him to a home right down the street from them so it would be closer and making caring for him easier. He was able to walk with a walker. He does not drive anymore since he had an accident a months ago. He has no children and his siblings are dead. He has been able to go to church and he would go on Friday night to play cards with a few other couples in the town down the road. He started having some Covid symptoms on Sunday, 9/12. He was a little congested and said he just did not feel good. Thursday he could not get off the couch and was so weak. He had them call the priest and he did visit and gave pt his last rites. Pt?s Nephew?s daughter did a Home Covid test on pt Thursday, 9/16 and he tested positive for Covid. Patient has been vaccinated. He did go Saturday and have the antibody infusion and he was gradually regaining his strength and almost back to his former activity they said. He took a shower on Saturday and was able to get it out by himself. He also was able to sit up on the couch and watch the ball game on Sunday. Yesterday morning he was doing pretty good and able to sit up and go to the bathroom and then about 3 o?clock this afternoon they went to check on him and could not arouse him. His oxygen level was down to 75% and his heart rate was 35. Before that his oxygen level had only gotten down to 94% at its lowest. Patient told them he did not want to go to the hospital . When they called this nurse they were just beside theirself and did not know what to do. Patient was anxious and moaning and confused. They could not get him settled. ?Hen? is a patient of Dr. It was so late in the day but they were afraid that something might happen to him during the night and they would not know what to do and they would not be able to have any medication and that patient would have to be taken to the hospital and that is not what he wanted. This nurse called RN at the care center and She did get a hold of Dr. He was still in the office and so was Dr. Dr. called back and said that pt could admitted him under the diagnosis of Covid, hypoxia, and hypertension. She wold also cover pt." Hospice Nurse'' Note on 9/22/2021 @ 06:50 CDT: "Pt?s great niece called and reported that pt?s O2 sat were down to 72% and his HR was 131. At 5:30 this am his O2 sat was in the 80s and was staying up in the 80s all night until now. They have been struggling to keep the O2 nc on pt during the night. He was alert enough to tell them that he did not want the O2 on. The morphine has helped pt but it does not last long. He keeps asking for his nephew. He says hat he wants up to the bathroom and then says no. When he does sleep he makes noises and he is very anxious and jabbering. He is drinking small sips of water. This nurse will visit soon." Pt expired later on that day. Nurse''s note @14:06 CDT: "Post mortem care provided. Controlled medications disposed of per protocol. Company contacted and patient ruled out due to age. Provisional Report completed and signed by pt?s nephew and great niece. Request put in the system and to contact nephew to set up date and time. Body released to Funeral Home. Emotional support provided throughout visit. Informed family of bereavement services."


VAERS ID: 1876991 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-30
Onset:2021-11-17
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Condition aggravated, Coronary artery bypass, Coronary artery disease, Dyspnoea exertional, Electrocardiogram abnormal, Positron emission tomogram abnormal, Road traffic accident
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Outpatient Medications albuterol HFA 108 (90 Base) MCG/ACT inhaler atorvastatin (LIPITOR) 40 MG tablet blood glucometer system carBAMazepine (TEGRETOL XR) 100 MG 12 hr tablet DULoxetine (CYMBALTA) 60 MG capsule gabapentin (NEURONTIN)
Current Illness:
Preexisting Conditions: Cardiovascular and Mediastinum Hypertension Coronary artery disease involving native coronary artery of native heart without angina pectoris Coronary artery disease involving native coronary artery of native heart with angina pectoris CAD in native artery PAF (paroxysmal atrial fibrillation) Respiratory Acute respiratory failure Endocrine Type 2 diabetes mellitus with complication, without long-term current use of insulin Secondary diabetes mellitus without complications Musculoskeletal and Integument Patellofemoral arthritis Genitourinary Pyelonephritis Renal insufficiency Other Renal colic Chest pain Abnormal stress test Dyslipidemia Morbid obesity with BMI of 40.0-44.9, adult Hernia of abdominal wall Abnormal nuclear stress test
Allergies: MorphineAnaphylaxis Vitamin CNausea And Vomiting Citric Acid-potassium Citrate [Potassium Citrate]Nausea And Vomiting Orange Juice [Orange Oil] Pcn [Penicillins]
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 61 yr/o female who presents today for cardiac evaluation for chest pain, abnormal EKG and prior history of coronary artery disease. Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time. 61 yo woman previously evaluated in office for CAD, who was involved in a MVA. She was seen and cleared by NS to have CABG. She has not been in a neck brace since initial visit. Patient denies any issues or changes since last visit.


VAERS ID: 1366783 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Haemorrhage, Injury, Physical examination, Road traffic accident, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-25
   Days after onset: 24
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: Artificial cardiac pacemaker user; COPD
Preexisting Conditions: Comments: The patient was on unspecified respiratory medications and blood thinners.
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Result Unstructured Data: positive; Test Date: 202105; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: positive; Test Date: 202105; Test Name: COVID-19 virus test; Result Unstructured Data: not reported; Test Date: 202105; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: positive; Test Date: 20210518; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: negative; Test Date: 20210518; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: negative; Test Name: Physical examination; Result Unstructured Data: not reported
CDC Split Type: USJNJFOC20210554454

Write-up: MASSIVE BLUNT FORCE TRAUMA; CAR ACCIDENT; BLEEDING PROBLEMS; FELT PUNK; POSITIVE COVID TEST/ CONFIRMED COVID-19 INFECTION; This spontaneous report received from a consumer concerned an 77year old male. The patient''s weight was 216 pounds, and height was 65 inches. The patient''s concurrent conditions included pacemaker, and copd (Chronic obstructive pulmonary disease), and other pre-existing medical conditions included the patient was on respiratory medications and blood thinners. The patient was previously treated with warfarin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, Expiry :unknown) dose was not reported, 1 total, administered on 10-MAY-2021 for prophylactic vaccination. The batch number was not provided and has been requested. On an unspecified date in JAN-2021, Laboratory data included: COVID-19 virus test (NR: not provided) positive. The patient felt a little punk from the vaccine initially. On 18-MAY-2021, the patient was in a car accident. He was driving a truck and got T-boned by a car and pushed 40 feet into a ditch. He was hospitalized and had 2 negative rapid tests for COVID. He decompensated and was intubated. Upon intubation, another rapid COVID test was done and was positive. They did an additional test that was also positive. He passed away on 25-MAY-2021. An autopsy was performed on an unspecified date. It was reported that she believed the cause of death to be the massive blunt force trauma and bleeding problems. He tested positive for COVID with a 5 day test in JAN-2021. During that time, he had received the monoclonal infusion. She noted that he did not get ivermectin. He also got a physical examination done. Laboratory data included: COVID-19 virus test (NR: not provided) not reported, and SARS-CoV-2 rapid diagnostic test (NR: not provided) positive, positive. Laboratory data included: SARS-CoV-2 rapid diagnostic test (NR: not provided) negative, negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of massive blunt force trauma and bleeding problems on 25-MAY-2021, and the outcome of positive covid test/ confirmed covid-19 infection, car accident and felt punk was not reported. This report was serious (Death, and Hospitalization Caused / Prolonged).; Sender''s Comments: V0. 20210554454-COVID-19 VACCINE AD26.COV2.S. Massive blunt force trauma, bleeding problems, car accident. This events is considered unassessable. The events have an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the events.; Reported Cause(s) of Death: MASSIVE BLUNT FORCE TRAUMA; BLEEDING


VAERS ID: 1854556 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-11-08
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Death, Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-08
   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: Diabetes type 1, thyroid cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: vaccine Dose 1 given 3/30/2021 Moderna Lot # 020B21A Pt died in the ER following a motor vehicle accident


VAERS ID: 1004811 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-09
Onset:2021-01-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Autopsy, Bone fragmentation, Computerised tomogram abnormal, Computerised tomogram spine, Death, Headache, Injury, Road traffic accident, Spinal compression fracture, Spinal stenosis, Subdural haematoma, Unresponsive to stimuli
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: unknown
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT lumbar spine: L4 compression fracture w/ retropulsion of fragments causing moderate narrowing of spinal canal
CDC Split Type:

Write-up: On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma.


VAERS ID: 1281748 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-09
Onset:2021-03-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aortic dissection, Cardiac arrest, Muscle twitching, Pain in extremity, Road traffic accident
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), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Accidents and injuries (narrow), Cardiomyopathy (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: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ozempic Zinc Atorvastatin Calcium Metformin HCL Lisinopril Jardiance was prescribed on 3/16 but hadn''t picked it up yet
Current Illness: none
Preexisting Conditions: diabetic ulcer on foot
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Janssen COVID-19 Vaccine EUA" 3/18 twitching of foot...severe leg pain 7:45 PM 3/19 involved in a motor vehicle accident with cardiac arrest and a dissecting aortic aneurysm 12;45 PM


VAERS ID: 1233769 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-25
Onset:2021-04-06
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Injury, Road traffic accident
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: According to death certificate patient died of "blunt force injuries from a motorcycle accident"


VAERS ID: 1700712 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-14
Onset:2021-09-08
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Endotracheal intubation, Injury, Multiple fractures, Road traffic accident, SARS-CoV-2 test positive, Skull fractured base, Subarachnoid haemorrhage
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (narrow), Hostility/aggression (broad), Osteoporosis/osteopenia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-14
   Days after onset: 6
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 presented to hospital in full trauma alert after motorcycle crash on 9/8. Intubated with subarachnoid hemorrhage with base skull fracture and multiple other fractures. Covid test +. No improvement with multiple trauma appropriate treatments. Family agreed with comfort care on 9/13.


VAERS ID: 1935630 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-19
Onset:2021-09-25
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Arteriosclerosis, Autopsy, Death, Giant cell myocarditis, Hypertensive heart disease, Road traffic accident
SMQs:, Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-25
   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: benazepril 20 mg per day, hctz 25 mg per day
Current Illness: none
Preexisting Conditions: benign essential hypertension, dyslipidemia, obesity class I
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was declared deceased on scene of a single-person motor vehicle accident on 09/25/2021. His vehicle left the road with no evidence that he had tried to slow the vehicle or correct course. An autopsy was performed and the primary cause of death was determined to be giant cell myocarditis (GCM) with contributing factors of hypertensive and artherosclerotic heart disease. Subject contracted COVID in November 2020, and had the Pfizer COVID vaccinations in March 19th and April 9th, 2021.


VAERS ID: 1917303 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-11-12
Onset:2021-11-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Road traffic accident
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Died on 11/14/2021-car accident


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=CAT&EVENTS=ON&PERPAGE=600&ESORT=STATE&SYMPTOMS=Road+traffic+accident+%2810039203%29&VAX=COVID19&DIED=Yes


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166