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From the 10/8/2021 release of VAERS data:

Found 57 cases where Age is 30-or-more-and-under-40 or 40-or-more-and-under-50 or 50-or-more-and-under-60 and Number of Vaccines Administered is '2' and Vaccine targets COVID-19 (COVID19) and Manufacturer is PFIZER/BIONTECH and Symptom is Death and Patient Died and Date of Death from '2019-01-01' to '2021-12-31'

Table

   
VAERS FormYear,Month,Day of VaccinationManufacturersAgeYear,Month,Day of DeathCountPercent
22021-01-06PFIZER/BIONTECH44-65 Years2021-09-2323.51%
2021-01-06PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-06PFIZER/BIONTECHtotal23.51%
2021-01-06total23.51%
2021-01-07PFIZER/BIONTECH17-44 Years2021-01-1223.51%
2021-01-07PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-01-07PFIZER/BIONTECHtotal23.51%
2021-01-07total23.51%
2021-01-08PFIZER/BIONTECH44-65 Years2021-03-0723.51%
2021-01-08PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-08PFIZER/BIONTECHtotal23.51%
2021-01-08total23.51%
2021-01-09PFIZER/BIONTECH17-44 Years2021-02-0823.51%
2021-01-09PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-01-09PFIZER/BIONTECHtotal23.51%
2021-01-09total23.51%
2021-01-12PFIZER/BIONTECH17-44 Years2021-06-1923.51%
2021-01-12PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-01-12PFIZER/BIONTECH44-65 Years2021-01-1423.51%
2021-01-12PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-12PFIZER/BIONTECHtotal47.02%
2021-01-12total47.02%
2021-01-14PFIZER/BIONTECH44-65 Years2021-03-3023.51%
2021-01-14PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-14PFIZER/BIONTECHtotal23.51%
2021-01-14total23.51%
2021-01-18PFIZER/BIONTECH44-65 Years2021-05-1023.51%
2021-01-18PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-18PFIZER/BIONTECHtotal23.51%
2021-01-18total23.51%
2021-01-27PFIZER/BIONTECH44-65 Years2021-02-0423.51%
2021-01-27PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-01-27PFIZER/BIONTECHtotal23.51%
2021-01-27total23.51%
2021-02-17PFIZER/BIONTECH17-44 Years2021-05-0323.51%
2021-02-17PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-02-17PFIZER/BIONTECH44-65 Years2021-03-1623.51%
2021-02-17PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-17PFIZER/BIONTECHtotal47.02%
2021-02-17total47.02%
2021-02-19PFIZER/BIONTECH44-65 Years2021-08-3123.51%
2021-02-19PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-19PFIZER/BIONTECHtotal23.51%
2021-02-19total23.51%
2021-02-21PFIZER/BIONTECH44-65 Years2021-08-2923.51%
2021-02-21PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-21PFIZER/BIONTECHtotal23.51%
2021-02-21total23.51%
2021-02-24PFIZER/BIONTECH44-65 Years2021-05-0923.51%
2021-02-24PFIZER/BIONTECH44-65 Years2021-09-0923.51%
2021-02-24PFIZER/BIONTECH44-65 Yearstotal47.02%
2021-02-24PFIZER/BIONTECHtotal47.02%
2021-02-24total47.02%
2021-02-25PFIZER/BIONTECH44-65 Years2021-03-2423.51%
2021-02-25PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-25PFIZER/BIONTECHtotal23.51%
2021-02-25total23.51%
2021-02-27PFIZER/BIONTECH44-65 Years2021-09-2023.51%
2021-02-27PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-27PFIZER/BIONTECHtotal23.51%
2021-02-27total23.51%
2021-02-28PFIZER/BIONTECH44-65 Years2021-03-2723.51%
2021-02-28PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-02-28PFIZER/BIONTECHtotal23.51%
2021-02-28total23.51%
2021-03-01PFIZER/BIONTECH44-65 Years2021-03-0523.51%
2021-03-01PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-03-01PFIZER/BIONTECHtotal23.51%
2021-03-01total23.51%
2021-03-09PFIZER/BIONTECH17-44 Years2021-03-1123.51%
2021-03-09PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-03-09PFIZER/BIONTECHtotal23.51%
2021-03-09total23.51%
2021-03-12PFIZER/BIONTECH44-65 Years2021-06-0923.51%
2021-03-12PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-03-12PFIZER/BIONTECHtotal23.51%
2021-03-12total23.51%
2021-03-24PFIZER/BIONTECH44-65 Years2021-03-2523.51%
2021-03-24PFIZER/BIONTECH44-65 Years2021-05-3023.51%
2021-03-24PFIZER/BIONTECH44-65 Yearstotal47.02%
2021-03-24PFIZER/BIONTECHtotal47.02%
2021-03-24total47.02%
2021-03-25PFIZER/BIONTECH44-65 Years2021-09-1723.51%
2021-03-25PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-03-25PFIZER/BIONTECHtotal23.51%
2021-03-25total23.51%
2021-03-26PFIZER/BIONTECH44-65 Years2021-03-2923.51%
2021-03-26PFIZER/BIONTECH44-65 Years2021-06-0723.51%
2021-03-26PFIZER/BIONTECH44-65 Years2021-08-2423.51%
2021-03-26PFIZER/BIONTECH44-65 Yearstotal610.53%
2021-03-26PFIZER/BIONTECHtotal610.53%
2021-03-26total610.53%
2021-03-31PFIZER/BIONTECH17-44 Years2021-05-1123.51%
2021-03-31PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-03-31PFIZER/BIONTECH44-65 Years2021-09-0523.51%
2021-03-31PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-03-31PFIZER/BIONTECHtotal47.02%
2021-03-31total47.02%
2021-04-06PFIZER/BIONTECH44-65 Years2021-04-1323.51%
2021-04-06PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-06PFIZER/BIONTECHtotal23.51%
2021-04-06total23.51%
2021-04-07PFIZER/BIONTECH17-44 Years2021-05-1023.51%
2021-04-07PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-04-07PFIZER/BIONTECHtotal23.51%
2021-04-07total23.51%
2021-04-08PFIZER/BIONTECH44-65 Years2021-09-2823.51%
2021-04-08PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-08PFIZER/BIONTECHtotal23.51%
2021-04-08total23.51%
2021-04-09PFIZER/BIONTECH17-44 Years2021-04-1123.51%
2021-04-09PFIZER/BIONTECH17-44 Years2021-06-0323.51%
2021-04-09PFIZER/BIONTECH17-44 Yearstotal47.02%
2021-04-09PFIZER/BIONTECHtotal47.02%
2021-04-09total47.02%
2021-04-10PFIZER/BIONTECH44-65 Years2021-05-0123.51%
2021-04-10PFIZER/BIONTECH44-65 Years2021-05-0423.51%
2021-04-10PFIZER/BIONTECH44-65 Years2021-07-2923.51%
2021-04-10PFIZER/BIONTECH44-65 Yearstotal610.53%
2021-04-10PFIZER/BIONTECHtotal610.53%
2021-04-10total610.53%
2021-04-14PFIZER/BIONTECH17-44 Years2021-04-2223.51%
2021-04-14PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-04-14PFIZER/BIONTECH44-65 Years2021-05-2823.51%
2021-04-14PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-14PFIZER/BIONTECHtotal47.02%
2021-04-14total47.02%
2021-04-15PFIZER/BIONTECH17-44 Years2021-08-1023.51%
2021-04-15PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-04-15PFIZER/BIONTECHtotal23.51%
2021-04-15total23.51%
2021-04-17PFIZER/BIONTECH44-65 Years2021-07-2323.51%
2021-04-17PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-17PFIZER/BIONTECHtotal23.51%
2021-04-17total23.51%
2021-04-21PFIZER/BIONTECH44-65 Years2021-09-2623.51%
2021-04-21PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-21PFIZER/BIONTECHtotal23.51%
2021-04-21total23.51%
2021-04-23PFIZER/BIONTECH44-65 Years2021-10-0423.51%
2021-04-23PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-04-23PFIZER/BIONTECHtotal23.51%
2021-04-23total23.51%
2021-04-27PFIZER/BIONTECH17-44 Years2021-05-1823.51%
2021-04-27PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-04-27PFIZER/BIONTECHtotal23.51%
2021-04-27total23.51%
2021-05-03PFIZER/BIONTECH44-65 Years2021-07-2423.51%
2021-05-03PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-05-03PFIZER/BIONTECHtotal23.51%
2021-05-03total23.51%
2021-05-05PFIZER/BIONTECH44-65 Years2021-07-1023.51%
2021-05-05PFIZER/BIONTECH44-65 Years2021-08-1423.51%
2021-05-05PFIZER/BIONTECH44-65 Yearstotal47.02%
2021-05-05PFIZER/BIONTECHtotal47.02%
2021-05-05total47.02%
2021-05-10PFIZER/BIONTECH44-65 Years2021-06-0623.51%
2021-05-10PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-05-10PFIZER/BIONTECHtotal23.51%
2021-05-10total23.51%
2021-05-13PFIZER/BIONTECH44-65 Years2021-05-1523.51%
2021-05-13PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-05-13PFIZER/BIONTECHtotal23.51%
2021-05-13total23.51%
2021-05-15MODERNA44-65 Years2021-08-1811.75%
2021-05-15MODERNA44-65 Yearstotal11.75%
2021-05-15MODERNAtotal11.75%
2021-05-15PFIZER/BIONTECH44-65 Years2021-08-1811.75%
2021-05-15PFIZER/BIONTECH44-65 Yearstotal11.75%
2021-05-15PFIZER/BIONTECHtotal11.75%
2021-05-15total23.51%
2021-05-21PFIZER/BIONTECH44-65 Years2021-05-2323.51%
2021-05-21PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-05-21PFIZER/BIONTECHtotal23.51%
2021-05-21total23.51%
2021-05-24PFIZER/BIONTECH44-65 Years2021-05-3123.51%
2021-05-24PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-05-24PFIZER/BIONTECHtotal23.51%
2021-05-24total23.51%
2021-05-27PFIZER/BIONTECH17-44 Years2021-06-3023.51%
2021-05-27PFIZER/BIONTECH17-44 Yearstotal23.51%
2021-05-27PFIZER/BIONTECHtotal23.51%
2021-05-27total23.51%
2021-06-04PFIZER/BIONTECH44-65 Years2021-08-1023.51%
2021-06-04PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-06-04PFIZER/BIONTECHtotal23.51%
2021-06-04total23.51%
2021-06-16PFIZER/BIONTECH44-65 Years2021-06-1723.51%
2021-06-16PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-06-16PFIZER/BIONTECHtotal23.51%
2021-06-16total23.51%
2021-07-08PFIZER/BIONTECH44-65 Years2021-07-1623.51%
2021-07-08PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-07-08PFIZER/BIONTECHtotal23.51%
2021-07-08total23.51%
2021-08-20PFIZER/BIONTECH44-65 Years2021-08-2223.51%
2021-08-20PFIZER/BIONTECH44-65 Yearstotal23.51%
2021-08-20PFIZER/BIONTECHtotal23.51%
2021-08-20total23.51%
total114200%
TOTAL† 114† 200%
† 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 57 (the number of cases found), and the Total Percentage is greater than 100.



Case Details

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VAERS ID: 944595 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-12
Onset:2021-01-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Brain death, Cardiac arrest, Death, Intensive care, Life support, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-14
   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: losartan, spironolactone, carvedilol
Current Illness: No known new illnesses,
Preexisting Conditions: Cardiomyopathy
Allergies: nkda
Diagnostic Lab Data: mulitple Full ER code and then ICU support for 2 days
CDC Split Type:

Write-up: Cardiac arrest within 1 hour Patient had the second vaccine approximately 2 pm on Tuesday Jan 12th He works at the extended care community and was in good health that morning with no complaints. He waited 10-15 minutes at the vaccine admin site and then told them he felt fine and was ready to get back to work. He then was found unresponsive at 3 pm within an hour of the 2nd vaccine. EMS called immediately worked on him 30 minutes in field then 30 minutes at ER was able to put him on life support yet deemed Brain dead 1-14-21 and pronounced dead an hour or so later


VAERS ID: 948418 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-07
Onset:2021-01-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-12
   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: Unknown
Current Illness: Received 1st Covid vaccine 12/18/2020; 2nd 1/7/2021. This patient is now deceased 1/12/2021.
Preexisting Conditions: Per patient health history: hearing loss, asthma, bronchiolitis, chronic cough, anemia, depression
Allergies: No known
Diagnostic Lab Data: Autopsy pending;
CDC Split Type:

Write-up: Expired on 1/12/2021; unknown cause of death


VAERS ID: 1019670 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-27
Onset:2021-02-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Anion gap, Aspartate aminotransferase increased, Asthenia, Bacterial test positive, Base excess, Basophil count increased, Bilirubin urine, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bicarbonate increased, Blood bilirubin normal, Blood calcium decreased, Blood chloride decreased, Blood creatine phosphokinase MB decreased, Blood creatine phosphokinase normal, Blood creatinine increased, Blood glucose increased, Blood lactic acid normal, Blood pH decreased, Blood potassium normal, Blood sodium decreased, Blood sodium normal, Blood urea increased, Blood urea nitrogen/creatinine ratio increased, C-reactive protein normal, Carbon dioxide decreased, Cardiac arrest, Chest X-ray abnormal, Chromaturia, Creatine urine increased, Crystal urine present, Death, Differential white blood cell count normal, Dysuria, Endotracheal intubation, Eosinophil count decreased, Erythema, Fluid overload, Full blood count normal, Globulins decreased, Glomerular filtration rate decreased, Glucose urine absent, Haematocrit normal, Haemoglobin decreased, Hypoperfusion, Hypotension, Immature granulocyte count increased, Influenza virus test negative, Intestinal ischaemia, Lipase, Lung opacity, Lymphocyte count normal, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume increased, Mean platelet volume normal, Metabolic function test, Metamyelocyte percentage, Monocyte count decreased, Monocyte count normal, Neutrophil count, Neutrophil count normal, Nitrite urine absent, Opiates negative, Oxygen saturation decreased, PCO2 increased, PO2 normal, Platelet count normal, Pleural effusion, Pneumonia aspiration, Pneumonitis, Procalcitonin decreased, Protein total decreased, Protein urine present, Pulse absent, Pyrexia, Red blood cell count decreased, Red blood cell sedimentation rate normal, Red blood cells urine, Red cell distribution width increased, Resuscitation, Rib fracture, SARS-CoV-2 test negative, Small intestinal obstruction, Specific gravity urine normal, Toxicologic test normal, Troponin I normal, Urinary casts, Urinary lipids present, Urinary occult blood positive, Urine analysis, Urine analysis abnormal, Urine analysis normal, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine, Vomiting, White blood cell count normal, White blood cells urine positive, pH urine normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (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), 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), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Ischaemic colitis (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Osteoporosis/osteopenia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   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:
Current Illness:
Preexisting Conditions: Cerebral Palsy, Anxiety, Crohns, Bipolar, GERD, Nutrition deficiency, Iron deficiency
Allergies: lactose
Diagnostic Lab Data: 2/2/2021- CDC, CMP, Lipase, UA, CXR. COVID negative, Influenza Negative. WBC 8.2, HCT 48.2, HGB 16.3, CRP 4.9, NA 135, K+ 4.0, CHL 94, Bicarb 33, BUN 29, Creatinine 0.8, Glucose 145, Alkaline Phosphatase 106, Lipase 24. UA negative. 2/4/2021- 02/04 02/04 02/04 2145 2039 2039 Blood Gas VBG pH (7.31 - 7.41) 6.99 VBG pCO2 (40 - 50 mmHg) 73 VBG pO2 (40 - 50 mmHg) 81 VBG HCO3 (22.0 - 26.00 mmol/L) 17.7 VBG O2 Sat (Meas) (%) 85.8 VBG Base Excess (-2 TO 3 mmol/L) -14.9 VBG Lactic Acid (0.5 - 2.2 mmol/L) 10.1 Chemistry Sodium (135 - 148 mmol/L) 133 Potassium (3.6 - 5.2 mmol/L) 4.2 Chloride (98 - 107 mmol/L) 101 Carbon Dioxide (21 - 32 mmol/L) 18 Anion Gap (mmol/L) 14 BUN (7 - 25 mg/dL) 40 Creatinine (0.7 - 1.5 mg/dL) 1.4 Estimated GFR ($g60) 56 BUN/Creatinine Ratio 28.6 Glucose (70 - 110 mg/dL) 212 Calcium (8.4 - 10.2 mg/dL) 7.4 Total Bilirubin (0.1 - 1.5 mg/dL) 0.4 AST (5 - 40 U/L) 41 ALT (7 - 52 U/L) 40 Alkaline Phosphatase (34 - 104 U/L) 112 Creatine Kinase (35 - 232 U/L) 95 CK-MB (CK-2) (0.6 - 6.3 ng/mL) 2.8 Troponin I (<=0.03 ng/mL) 0.05 C-Reactive Prot, Quant (0.1 - 0.3 mg/dL) 5.7 Serum Total Protein (6.0 - 8.3 g/dL) 4.3 Albumin (3.5 - 5.0 g/dL) 2.6 Globulin (g/dL) 1.7 Albumin/Globulin Ratio 1.5 Procalcitonin (< 0.1 ng/mL) 0.7 Hematology WBC (4.0 - 11.0 K/uL) 6.9 RBC (4.30 - 5.70 M/uL) 4.39 Hgb (13.0 - 17.4 g/dL) 13.4 Hct (39.0 - 52.2 %) 42.8 MCV (80 - 100 fL) 98 MCH (25.0 - 35.0 pg) 31 MCHC (31 - 36 g/dL) 31 RDW Coeff of Var (11.0 - 16.0 %) 14.6 Plt Count (150 - 450 K/uL) 239 MPV (9.4 - 12.4 fL) 9.5 Immature Gran % (Auto) (0.1 - 0.3 %) 13.8 Neut % (Auto) (37.0 - 80.0 %) 56.2 Lymph % (Auto) (10.0 - 50.0 %) 21.8 Mono % (Auto) (0.0 - 12.0 %) 4.9 Eos % (Auto) (0.0 - 5.0 %) 0.6 Baso % (Auto) (0.0 - 3.0 %) 2.7 Immature Gran # (Auto) (0.01 - 0.03 K/uL) 0.96 Absolute Neuts (auto) (2.00 - 8.00 K/uL) 3.90 Absolute Lymphs (auto) (1.00 - 5.00 K/uL) 1.51 Absolute Monos (auto) (0.00 - 1.20 K/uL) 0.34 Absolute Eos (auto) (0.00 - 0.50 K/uL) 0.04 Absolute Basos (auto) (0.00 - 0.30 K/uL) 0.19 Total Counted (CELLS) 100 Neutrophils % (Manual) (37 - 80 %) 41 Band Neutrophils % (< 6 %) 12 Lymphocytes % (Manual) (10 - 50 %) 37 Monocytes % (Manual) (0 - 12 %) 8 Eosinophils % (Manual) (1 - 7 %) 0 Basophils % (Manual) (<4 %) 0 Metamyelocytes % (%) 2 Nucl RBC Rel Cnt (Man) (/100 WBC) 2 ESR (0 - 20 mm/hr) 4 Toxicology Urine Opiates Screen (NEG) NEG Ur Oxycodone Screen (NEG) NEG Urine Methadone Screen (NEG) NEG Ur Propoxyphene Screen (NEG) NEG Ur Barbiturates Screen (NEG) NEG U Tricyclic Antidepress (NEG) NEG Ur Phencyclidine Scrn (NEG) NEG Ur Amphetamines Screen (NEG) NEG U Methamphetamines Scrn (NEG) NEG U Benzodiazepines Scrn (NEG) NEG Urine Cocaine Screen (NEG) NEG U Marijuana (THC) Screen (NEG) NEG Urines Urine Source URINE - FOLEY CATH Urine Color YELLOW Urine Appearance (CLEAR/HAZY) TURBID Urine pH (5 - 9) 5.5 Ur Specific Gravity (1.005 - 1.030) $g=1.030 Urine Protein (NEG/TRACE mg/dL) $g=300 Urine Glucose (UA) (NEG mg/dL) NEGATIVE Urine Ketones (NEG mg/dL) 15 Urine Occult Blood (NEG) LARGE Urine Nitrite (NEG) NEGATIVE Urine Bilirubin (NEG) MODERATE Urine Urobilinogen (0.2 - 1.0 E.U./dL) 0.2 Ur Leukocyte Esterase (NEG) NEGATIVE Urine RBC (<3 /HPF) 11-20 Urine WBC (<6 /HPF) $g100 Ur Squamous Epith Cells (/HPF) RARE Amorphous Crystals (/HPF) MOD Urine Bacteria (/HPF) FEW Hyaline Casts (NONE SEEN /LPF) FEW Fine Granular Casts (NONE SEEN /LPF) FEW Urine Mucus (/LPH) FEW Ur Oval Fat Bodies (NONE SEEN /HPF) FEW Vol Urine Centrifuged (mL) 5 U Random Total Protein (mg/dL) 446 U Rand Prot/Creat Ratio (LT 0.2 RATIO) ND Urine Creatinine (mg/dL) 94
CDC Split Type:

Write-up: 2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose. Redness to bilateral upper extremities, c/o some pain with urination, weak. V/S stable, afebrile in ED. Assess for infection. No significant abnormal labs (see below), hydrated and discharged. 2/4/2021- arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn. Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started. -Please see HPI above, in addition after intubation the patient coded again. More epinephrine and lidocaine were given. CPR was resumed. We did obtain ROSC and targeted temperature management was pursued. He is placed on a lidocaine drip and a right femoral central line was placed by myself. At this time, norepinephrine drip was initiated given his continued hypotension. Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained. He did lose pulses once in the radiology suite. This was brief. IV fluids were initiated and he received over 2 L of crystalloid therapy. He continued to be hypotensive in the emergency department and vasopressin was added. He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up. CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant. I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times. He was given IV bicarbonate given his prolonged CPR state and pH. Ultimately, the family decided to make the patient comfort measures only given his critical illness. Shortly after making this decision he did pass away in the emergency department. RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia. Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities. Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process. No evidence of mass effect, acute hemorrhage or definite acute cortical infarct. Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through


VAERS ID: 1044420 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-09
Onset:2021-01-31
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood creatinine normal, Blood fibrinogen increased, Blood lactic acid, Blood sodium decreased, C-reactive protein increased, Cardiac arrest, Death, Diarrhoea, Fibrin D dimer increased, Multiple organ dysfunction syndrome, Myocarditis, Oropharyngeal pain, Platelet count decreased, Pyrexia, SARS-CoV-2 antibody test positive, Serum ferritin increased, Transaminases, Troponin increased, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), 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), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-08
   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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Sodium 131, creatinine 1.2 on admission, transaminases initially normal, lactic acid 2.6, white blood count 11.0, platelets 110, coronavirus nucleocapsid IgG positive, troponin 18, ferritin 1435, fibrinogen 642, D-dimer 5.22, CRP 284
CDC Split Type:

Write-up: Please reference separately submitted MIS-A form. He had sore throat, high fever, diarrhea, deteriorating in to multisystem failure and apparent acute myocarditis, notably with relative initial sparing of the lungs. He suffered cardiac arrest in radiology after developing aphasia and was transferred to Hospital after cannulation for VA ECMO; he died there 2/8/21.


VAERS ID: 1080538 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-01-08
Onset:2021-03-07
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-07
   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 known
Current Illness: none known
Preexisting Conditions: none known
Allergies: None reported
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Unexpected Death. No details known at this time.


VAERS ID: 1104175 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-09
Onset:2021-03-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 RA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Death, Decreased appetite, Headache, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-11
   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: Norethindrone .35MG Daily - Birth Control 10 MG Zyrtec Allergy Daily - Allergies 5000 mcg Biotin Gummy Daily - Hari, Skin & Nails Vitamin 50 mcg D3 Gummy Daily - Bone & Immune System Vitamin 45 mg Iron plus Vitamin C Soft Chew Daily - Vitam
Current Illness: None
Preexisting Conditions: Myotonic Dystrophy DM 1 - Congenital : characterized by progressive muscle wasting and weakness. Physical and Intellectual Disability
Allergies: None to Date
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: She received the 2nd Dose on 3/9/2021. On 3/10/2021 She complained of a headache. On the morning of 3/11/2021 she complained of abdominal pain and had no appetite. We then found her unresponsive, called 911 and the medics pronounced her at around 1300.


VAERS ID: 1141641 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-28
Onset:2021-03-02
   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 - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Computerised tomogram thorax abnormal, Death, Dyspnoea, Fatigue, General physical health deterioration, Nausea, Pneumonia viral, Pyrexia, SARS-CoV-2 test negative, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (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), 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: 2021-03-27
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: enalapril,furosemide,klor-con,levothroxine,carvedilol
Current Illness: Pneumonia
Preexisting Conditions: Chronic heart failure, aortic valve stenosis and insufficiency, dilated cardiomyopathy,hypothyrodism, lymphoma,
Allergies: No medication allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received first Pfizer Covid19 vaccine on 2/28/21. Developed fever 102.8, chills, SOB on 3/2/21 and was transported by EMS to ER and admitted. He was tested 3 times for COVID 19 and found to be negative. CT scan was concerning for viral pneumonia and suspected COVID. He was treated and released to home on 3/4/21. Followed by pulmonologist. Received second Pfizer COVID19 vaccine on 3/21/21. On 3/23/21 developed fatigue, weakness, shakiness, nausea and vomiting. had significant decline over the week. Has acute event on 3/27/21 and was pronounced dead at home.


VAERS ID: 1147783 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-25
   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: Had 2nd COVID shot died next day physician advised me to notify.


VAERS ID: 1203198 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Laboratory test, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-13
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: 4/11/21 taken to emergency room at hospital. Please contact for medical test and lab results showing PE.
CDC Split Type:

Write-up: Second vaccine received on 4/6/21. Pulmonary Embolism on 4/11/21. Death on 4/13/21.


VAERS ID: 1203510 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-11
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentine, Olanzaprine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unknown on any adverse events or symptoms


VAERS ID: 1209825 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-03-12
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: 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? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-16
   Days after onset: 3
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: Prednisone 5mg, Fluconazole, Valtrex 1x day
Current Illness:
Preexisting Conditions: CML ($g20 yrs ago), Rheumatoid Arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 03-13-2021, Diagnosed with Thrombotic Thrombocytopenic Purpura, Died 03-16-2021


VAERS ID: 1251028 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-14
Onset:2021-04-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Completed suicide, Death
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-22
   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: None that we know of
Current Illness: Depression
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death by suicide sometime between late evening Wednesday, April 21st, 2021 and early morning April 22nd, 2021. He was found at about 8am that morning.


VAERS ID: 1286760 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Death, Dyspnoea, Full blood count, HIV test, Hepatic failure, Liver function test, Metabolic function test, Pneumonia, Pyrexia, Respiratory distress
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), 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)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 23
Permanent Disability? No
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: None
Preexisting Conditions: depression, hypertension, high cholesterol,
Allergies: Penicillan
Diagnostic Lab Data: cbc, ast, alt, cmp, HIV screen, full liver panel, many others.
CDC Split Type:

Write-up: fever, shortness of breath, respiratory distress, pneumonia, liver failure, death.


VAERS ID: 1337058 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZERER8727 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZERER8727 / UNK UN / UN

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Brain stem haemorrhage, Cardiac arrest, Death, Gait disturbance, Mechanical ventilation, Respiratory arrest, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-29
   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: N/A
Current Illness: none
Preexisting Conditions: alcoholism
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally. The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021.


VAERS ID: 1338394 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-05-07
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Chest pain, Death, Fatigue, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-10
   Days after onset: 3
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: Death N17.9 - Acute kidney failure, unspecified FATIGUE CHEST PAIN NAUSEA


VAERS ID: 1348060 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Death, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-15
   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: No
Current Illness: No, but the medical examiner said sometime after the first Vaccine on 4/13/2021 he had a minor heart attack or some sort of heart issue that wasn''t big enough for him to realize to go to doctors. On second Vaccine is when he had Heart attack.
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: My father in law suffered a heart attacked on the day he received his second shot. at the time of this he was staying in our house where he wasn''t found until two days later when we received a call from his work saying he never showed up or called in to work. The medical examiner told us that prior to the second vaccine in the last few weeks he had suffered some sort of heart issue that damaged his heart, but wasn''t big enough for him to notice or think anything of it. The timeline the medical examiner gave us would have been after receiving the first vaccine. He then received his second Vaccine on a Thursday which was the last time anyone heard from him and he didn''t show up to work Friday and was found Saturday after we were notified he didn''t show up to work and we called 911. The medical examiner said he suffered a heart attack. The medical examiner said they had to write the death date on Saturday because that was when he was found, but the last anyone heard of him was prior to getting the vaccine and then he missed work the very next day(which was Friday).


VAERS ID: 1350670 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-02-25
Onset:2021-02-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8982 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Death, Decreased appetite, Hypersomnia, Loss of personal independence in daily activities, Mental status changes, Posture abnormal, Wheelchair user
SMQs:, Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-24
   Days after onset: 26
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ametriptolin, eliquis, seizure medicine
Current Illness:
Preexisting Conditions: Kidney disease
Allergies: Penicillin, msg
Diagnostic Lab Data:
CDC Split Type:

Write-up: After first dose her mental status become slightly altered and she leaned to the left a bit when standing up and walking.. From the day of second dose my sisters appetite decreased. She started sleeping more, got weaker to the point I had to bathe her, she had to start using a wheelchair. Mental status much more altered. She was to weak to go to dialysis on Monday March 22 2021 hospice was called in Tuesday March 23 2021 and she passed away at approximately 4:00 P.M. March 24th 2021.


VAERS ID: 1358345 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-05-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-01
   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: Vit. C, ASA 81mg, Calcium Carbonate with Vit. D, Clopidogrel 75mg, Iron, Folic acid, Gabapentin 900mg bid, HCTZ 25mg, Lisinopril 20mg, Magnesium, Metformin 500mg bid, Metoprolol XL 100mg, astrostatin 40mg, Tylenol 500mg , Wellbrutin 300mg,
Current Illness: none
Preexisting Conditions: Diabetes, 7- CABG, veracious veins, Hx of Kidney stones , HTN, Hx of gastric bypass, Hx of stroke (L Basilar) with hearing loss in L ear, Orchiectomy due to veracious vein,
Allergies: NKMA
Diagnostic Lab Data: na
CDC Split Type:

Write-up: My husband died May 1st, 3 weeks after his last vaccine April 10 . He had a saddle pulmonary emboli. He did not have any symptoms that I knew of prior to May 1st. Entering info for research data.


VAERS ID: 1365404 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-01
Onset:2021-03-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL 3246 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-05
   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: Plavix 75mg, Carvedilol 25mg, Amlodipine 10mg, Losartan 100mg, Lipitor 10mg, Allopurinol 25mg, Aspirin 81mg, Vitamin C, Vitamin D, CoQ10
Current Illness:
Preexisting Conditions: High blood pressure, gout, sleep apnea
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: My husband past away


VAERS ID: 1371338 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-05-31
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO161 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Delivery, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-03
   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: Prenatal vitamins
Current Illness: NA
Preexisting Conditions: asymptomatic Factor V Leiden, anxiety, insomnia
Allergies: No drug allergies
Diagnostic Lab Data: Autopsy pending
CDC Split Type:

Write-up: 32 year old female received vaccines while pregnant with her 3rd child. Pt has asymptomatic Factor V Leiden. She delivered on 5/27/2021 and passed away on 5/31/2021.


VAERS ID: 1374138 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-05-21
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Death
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-28
   Days after onset: 7
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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death - Non-ST elevation (NSTEMI) myocardial infarction


VAERS ID: 1381998 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-05-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood osmolarity decreased, Death, Hyponatraemia, Pneumonia
SMQs:, Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-06
   Days after onset: 13
Permanent Disability? No
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia


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: 1408206 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-26
Onset:2021-05-21
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-07
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban, 5 mg, BID ascorbic acid (vitamin C), 500 mg, DAILY chlorhexidine 0.12 % (for PERIDEX) solution, 15 mL, BID cloNIDine HCL, 0.1 mg, Q8H dilTIAZem, 30 mg, Q6 fluconazole (conc: 2 mg/mL), 200 mg, Q24H gabapentin, 100 mg, QHS insulin g
Current Illness: None
Preexisting Conditions: History of renal transplant
Allergies: Ace inhibitors, aspirin, barium sulfate, salicylates
Diagnostic Lab Data: 5/21/2021-positive COVID-19 test
CDC Split Type:

Write-up: Patient received both COVID vaccines. On 5/21/21 she presented to the ED with COVID symptoms. She was tested on 5/21/2021 and was positive for COVID-19. She died on 6/7/2021 in hospital from complications of COVID-19


VAERS ID: 1414219 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-16
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-17
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient was vaccinated on 5/26/21 for dose one and 6/16/21 for dose two with Pfizer COVID-19 vaccine. Patient passed away the day following her second dose on 6/17/21.


VAERS ID: 1416816 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-17
Onset:2021-05-03
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiomyopathy, Death, Depressed level of consciousness, Lethargy
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-03
   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: None
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: Death certificate states cardiomyopathy
CDC Split Type:

Write-up: Woke that morning very lethargic and hard to arouse. Mom states had been doing very well, exercising and losing weight. States he felt good up until that day. DEATH


VAERS ID: 1424021 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-04-15
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / UNK - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Death, Dizziness, Feeling abnormal
SMQs:, Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-30
   Days after onset: 45
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: furesomide carvedilol spironolactone
Current Illness: chf
Preexisting Conditions: chf
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had an acute MI died after within 8 weeks of last vaccine patient had been complaining of dizziness and feeling different since second vaccine


VAERS ID: 1430291 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER3781 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Cardiac failure, Chest X-ray, Chest discomfort, Computerised tomogram, Condition aggravated, Death, Dyspnoea, Echocardiogram, Electrocardiogram, Gait disturbance, Laboratory test, Pain, Palpitations, Peripheral ischaemia, Pulmonary hypertension, Skin discolouration, Ultrasound Doppler, Ventilation/perfusion scan
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-05-11
   Days after onset: 40
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole before vaccine Albuterol after 1st vaccine
Current Illness: Gastritis
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Multiple Lab blood tests done 5-6 to 5-10-21 TTE 5-7-21 Chest X-rays 5-9-21 Echocardiogram 5-6-21 Nuclear medicine ventilation perfusion lung 5-7-21 US lower extremity veins 5-7-21 ECG 12 lead 5-9-21 CT
CDC Split Type:

Write-up: Started with body aches, joint pain and weakness, followed by SOB that was aggravated over time- especially after the 2nd dose- Then, she started having increase heart palpitations and chest pressure. Eventually noted ischemic changes with purplish discoloration face, hands and feet. At this time it became great effort to walk due to lack of air- SOB was severe. She was taken to ER at hospital where she was admitted with possible PE, MI or heart failure. After few days no improvement was achieved and patient trans ported to another Hospital to receive more advance care but she was pronounced death in the morning of 5-11-21. The death certificate heart failure as immediate cause of death, preceded by PE and pulmonary hypertension.


VAERS ID: 1443056 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aortic dissection, Cardiac arrest, Cardiac tamponade, Chest pain, Cold sweat, Computerised tomogram abnormal, Death, Dyspnoea, Echocardiogram, Endotracheal intubation, Generalised tonic-clonic seizure, Haemorrhage, Hyperhidrosis, Hypotension, Loss of consciousness, Pericardial drainage, Pericardial effusion, Pericardial haemorrhage, Transfusion
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), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: HTN, electrolyte disorder, renal disease
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: 49yom with PMH HTN presents with CP and SOB. Ddx includes but is not limited to: ACS, PE, PNA, aortic dissection, pericarditis, myocarditis. On arrival, patient appeared critically ill with cool, clammy skin, diaphoretic, complaining of chest pain. Patient initially able to answer simple questions, however quickly became unconscious, witnessed having tonic colonic seizure activity. Patient given 2 mg of lorazepam which aborted the seizure, however he remained unresponsive. IV fluids were started, and patient remained hypotensive after 3 L of fluids. Bedside cardiac ultrasound was performed which showed a large pericardial effusion with tamponade physiology. We continued fluid resuscitation and patient was intubated, while stat Cardiology consult was called. Patient suffered a cardiac arrest shortly after intubation. Cardiology performed emergent pericardiocentesis at the bedside which showed hemopericardium with output of greater than 500 mL of blood. ROSC was achieved following pericardiocentesis, and we continued resuscitative measures. Emergent arterial line and central venous lines were placed. Patient began to have profuse bleeding from all orifices, and massive transfusion protocol was initiated. Patient was stabilized enough to be taken to CT scanner which showed an extensive aortic dissection extending into the RCA, abdominal aorta, brachiocephalic artery, common carotids, and into the abdominopelvic vasculature. Cardiac and vascular surgery were consulted stat, and the decision was made to take the patient emergently to the OR. We were informed shortly after that the patient had expired en route to the operating room and they were unable to obtain ROSC. Final impression: type A aortic dissection, cardiac tamponade. Second dose of mRNA vaccine (unknown if Pfizer or Moderna) received two days prior to event.


VAERS ID: 1464157 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-05-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Condition aggravated, Death, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-31
   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: Levemir 46 units twice daily Novolog 10 units three times daily before meals Ozempic 1 mg weekly Lisinopril 5 mg daily simvastatin 40 mg daily Tums 500 mg daily in the morning Omeprazole 20 mg daily Docusate 100 mg twice daily Albut
Current Illness: uncontrolled Type 2 diabetes acute hyponatremia
Preexisting Conditions: Hypertension CKD stage 3 Hyperlipidemia GERD History of small bowel obstruction Constipation Chronic Hepatitis C Bipolar affective disorder Fragile X syndrome ADHD Tardive dyskinesia generalized anxiety disorder tobacco abuse Seizure disorder COPD Neuropathy/pain Allergic Rhinitis Hypothyroidism Vitamin D deficiency
Allergies: copper (dermatitis) Nickel Olanzapine (nausea and vomiting) staples zinc Zyprexa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cardiac arrest, followed by seizure and death. Pt was hospitalized, undetermined cause of death, case send to a medical examiner. Case was noted upon chart review by reporter.


VAERS ID: 1474379 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-05
Onset:2021-06-11
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO0158 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO0179 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Aspiration pleural cavity, Autopsy, Biopsy bone marrow, Blood test abnormal, Catheterisation cardiac, Computerised tomogram, Death, Decreased appetite, Eosinophil count increased, Inflammation, Myocarditis, Nausea, Night sweats, Paraesthesia, Pericardial effusion, Pleural effusion, Pyrexia, White blood cell count increased, X-ray
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-10
   Days after onset: 29
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dulera, Albuterol, Multi-Vitamin, Ubiquinol, Vitamin D
Current Illness: None
Preexisting Conditions: Asthma
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11. This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER. Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count. There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed. After several days, patient returned to urgent care for follow-up bloodwork (June 20th). Results showed WBC and eosinophil count continued to escalate. He went to ER on June 25th and was admitted to the hospital for 5 days. During his visit at Hospital, he was seen by a team of specialists: cardiologist, pulmonologist, hematologist, infectious disease doctor. Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc. Patient had fluid around his heart and lungs and was diagnosed with myocarditis. He had no previous heart issues nor family history of heart issues. Test results indicated no abnormal blockage or other issues, other than inflammation and his heart strength was at 27%. I am unable to access his account, as it was disabled after his death. An autopsy is being performed and results are pending; however, the question(s) at large: what was the condition of his heart at the time of his death and was this vaccine-related? Did his myocarditis get worse? Did his heart muscle weaken further and rupture? Please let me know if the autopsy results are needed and where to send them.


VAERS ID: 1475006 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-27
Onset:2021-06-22
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal behaviour, Abscess drainage, Blood test, Computerised tomogram thorax abnormal, Cough, Death, Increased appetite, Lung abscess, Pneumonia, Skin warm, Somnolence, X-ray
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-06-30
   Days after onset: 8
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: Divalproex, Vyvanse, Risperidone, multivitamin, vitamin D3
Current Illness: None
Preexisting Conditions: ADHD, Epilepsy, Anxiety, Microcephalus, Autism, urinary incontinence, incontinence of feces
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. started coughing Tuesday, June 22, 2021, in the afternoon and it worsened through the rest of day. She also was beginning to be drowsy. Wednesday, June 23, 2021, coughing continued, she became drowsier, she felt warm to the touch (forehead, face, arms, back) and was not acting like herself. Thursday, June 24, 2021, 9am she was at the clinic. The doctor ordered an x-ray and blood work. After results arrived, we were advised to go to the emergency room. There the doctor ordered CT scan. The results showed an abscess and fluid in her left lung and pneumonia. Her lung was drained, was not able to get all of it out. They discussed surgery but needed to send pt. to ER. The discussion for surgery was a daily thing but never happened. They tried multiple procedures, CT scans, etc. On Tuesday, June 29, 2021 there was a meeting called with her doctor to discuss palliative care. The risk of surgery and all the complications following were high risk. Pt. did not understand that she needed to leave the IV and drainage tube in as well as leaving the oxygen on. Based on the complications and pts. quality of life after surgery and the fact that the fluid and pneumonia spread quickly throughout her body - the doctors were leaning towards end-of-life comfort. It all happened so fast! The evening of the 29th, pt. was transported home to end her life on hospice. On Wednesday, June 30, 2021 pt. passed away in the afternoon. Pt. was rarely ever sick. Once in a great while she would get a runny nose or little cough. Everyone around her would catch a virus and she simply would not. We had a member of our family test positive for COVID-19 in November 2020, and pt. never showed any symptoms of being ill. This was all before she received the COVID-19 Vaccine. About a week or two after she received the second vaccine, on May 27,2021. she had increased behaviors with eating and daily ADLs. But the behaviors were her ?normal? behaviors that would occasionally come and go. Nothing was ever persistent. Then on Tuesday June 22, 2021 when sick like symptoms started to appear it was less then four weeks after the second vaccine.


VAERS ID: 1484107 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-08
Onset:2021-07-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Death, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-16
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: arrhythmia, presumed MI, death


VAERS ID: 1502072 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-07-07
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Death, Gastrointestinal haemorrhage, Pneumonia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage terms (excl laboratory terms) (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), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-24
   Days after onset: 17
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: death J18.9 - Pneumonia, unspecified organism K92.2 - Gastrointestinal hemorrhage, unspecified N17.9 - Acute kidney failure, unspecified


VAERS ID: 1502098 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-06-28
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Death, Dyspnoea, Jaundice, Thrombocytopenia, Vaginal haemorrhage
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-23
   Days after onset: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death D69.6 - Thrombocytopenia, unspecified N93.9 - Vaginal bleeding JAUNDICE BLOATED SHORTNESS OF BREATH


VAERS ID: 1509756 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-03-12
Onset:2021-05-21
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-09
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Cancer
Allergies: Ascriptin, Aspirin
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient was hospitalized and passed away. 2nd vaccine given 4/6/2021


VAERS ID: 1512416 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-14
Onset:2021-03-26
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cardiac arrest, Cellulitis, Condition aggravated, Death, Respiratory arrest, SARS-CoV-2 test positive, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-30
   Days after onset: 4
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: Cellulitis
Preexisting Conditions: Morbid obesity, chronic respiratory failure
Allergies:
Diagnostic Lab Data: Tested positive for COVID on 03/26/2021
CDC Split Type:

Write-up: Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest.


VAERS ID: 1512561 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-24
Onset:2021-05-08
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardio-respiratory arrest, Chest pain, Death, Intensive care, Pericardial drainage, Resuscitation, SARS-CoV-2 test positive, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Anaphylactic reaction (broad), 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 (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-09
   Days after onset: 1
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: Positive COVID test on 5/8/21
CDC Split Type:

Write-up: Patient received both doses of the Pfizer vaccine on 2/24/21 and 3/17/21. Patient came to the ER on 5/8/21 with chest pain, where she tested positive for COVID. While patient was receiving a precordial drain she went into V. tach but was successfully resuscitated. She went to ICU but went into cardiopulmonary arrest and died on 5/9/21.


VAERS ID: 1512749 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-12
Onset:2021-06-04
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breath sounds abnormal, COVID-19, Chronic respiratory failure, Condition aggravated, Death, Depressed level of consciousness, Mechanical ventilation, SARS-CoV-2 test positive, Tracheo-oesophageal fistula
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-19
   Days after onset: 15
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: Anoxic brain injury, DVT, HTN, seizures, pulmonary embolism, severe TBI, chronic respiratory failure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 39 Male tested positive 6/4/2021. Vaccinated with Pfizer 12/22/2021 & 1/12/2021. 6/4/2021 hospital admission for tracheo-esophageal fistula (TEF) transfer from hospital. Diminished breathing sounds, minimally conscious. Removed from ventilator support 6/17/2021. Problems at time of death 6/19/2021 - chronic respiratory failure, COVID-19, history of severe TBI, TEF, trach vent/PEG dependent.


VAERS ID: 1525780 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-05-16
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Pulmonary embolism, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-29
   Days after onset: 74
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: death Other pulmonary embolism without acute cor pulmonale Unspecified convulsions


VAERS ID: 1582161 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Death
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (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), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-10
   Days after onset: 64
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: death N17.9 - Acute kidney failure, unspecified


VAERS ID: 1592110 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-05
Onset:2021-07-26
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Death, Dyspnoea, Pain, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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: 2021-08-14
   Days after onset: 19
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: Allopurinol 300 mg QD, Amlodipine 5 mg QD, Aspirin 81 mg QD, Atorvastatin 40 mg QD, Carvedilol 6.25 mg BID, Docusate 100 mg BID, Gabapentin 400 mg QD, Metoclopramide 5 mg QD, Miralax 17 grams QD PRN, Sevelamer 3200 mg TID, Apresoline 100 mg
Current Illness:
Preexisting Conditions: Diabetes, ESRD on Dialysis, Hypertension
Allergies: Hydromorphone (Agitation)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia. Patient expired on 8/14/2021.


VAERS ID: 1660763 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Accidental overdose, Death, Gastrooesophageal reflux disease, Interchange of vaccine products, Lymphoma, Victim of abuse
SMQs:, Drug abuse and dependence (broad), Gastrointestinal nonspecific dysfunction (narrow), Malignant lymphomas (narrow), Medication errors (narrow), Haematological malignant tumours (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   Days after onset: 94
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hiv
Current Illness:
Preexisting Conditions: Hiv
Allergies:
Diagnostic Lab Data: So many I need a book please contact me for these about 20 in a few months 60 on 1 yr
CDC Split Type:

Write-up: Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn''t want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine .


VAERS ID: 1683454 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-21
Onset:2021-08-17
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL6203 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Death, Dyspnoea, Lung opacity, Mental status changes, Positive airway pressure therapy, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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: 2021-08-29
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate 70 mg every 7 days, cholecalciferol 5000 units daily, multivitamin daily, mycophenolate 250 mg twice daily, potassium citrate 10 mEq twice daily, prednisone 10 mg daily, sidenafil 20 mg three times daily, bactrim DS three times
Current Illness:
Preexisting Conditions: Interstitial lung disease, pulmonary hypertension, pulmonary fibrosis, thrombocytopenia, cirrhosis, esophageal varices
Allergies: Iodine
Diagnostic Lab Data: COVID Positive on 8/17/2021; CXR showed bilateral patchy peripheral airspace opacities on 8/17/2021
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient''s mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021.


VAERS ID: 1685242 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-19
Onset:2021-08-31
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cerebrovascular accident, Death, Endotracheal intubation, Extubation, Hypoaesthesia, Paraesthesia
SMQs:, Angioedema (broad), 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), Guillain-Barre syndrome (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-31
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes.


VAERS ID: 1694121 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-09-05
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 0
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:
Current Illness:
Preexisting Conditions: DM MORBID OBESTITY
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT EXPIRED ON 09/05/2021


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: 1696822 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-24
Onset:2021-08-14
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchoalveolar lavage, COVID-19, Candida test positive, Cardiac arrest, Chest X-ray abnormal, Death, Dyspnoea, Life support, Lung consolidation, Lung infiltration, Mechanical ventilation, SARS-CoV-2 test positive
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Interstitial lung disease (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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: 2021-09-09
   Days after onset: 26
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 26 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg Oral 2 times daily, aspirin 81 mg Oral Daily, atorvastatin 40 mg Oral Nightly, calcium carbonate 200 mg calcium (500 mg) 1 tablet Oral Daily, carvedilol 12.5 mg Oral 2 times daily with meals, ergocalciferol (vitamin D2) 50,0
Current Illness:
Preexisting Conditions: Hypertension, hyperlipidemia, hypothyroidism, renal transplant
Allergies: Adhesive
Diagnostic Lab Data: COVID Positive on 8/15/2021; CXR showed Patchy infiltrates mid & lower lung with focal consolidation right midlung on 8/14/2021; Positive bronchial wash for Candida on 8/21/2021
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021.


VAERS ID: 1715254 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-08-22
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Atrial fibrillation, COVID-19, Computerised tomogram thorax abnormal, Cough, Culture, Death, Dyspnoea, Endotracheal intubation, Heart rate increased, Hypoglycaemia, Hypotension, Intensive care, Metabolic acidosis, Pneumonia, Pulmonary cavitation, Renal failure, Renal impairment, Respiratory acidosis, Respiratory failure, SARS-CoV-2 test positive, Septic shock, Staphylococcal bacteraemia, Staphylococcus test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (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 (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: 2021-08-24
   Days after onset: 2
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID: Detected (8/22/2021)
CDC Split Type:

Write-up: 45 yo female s/p Pfizer COVID vaccination: dose 1 on 3/5 and dose 2 on 3/26. Past medical history significant for anemia of chronic disease, anxiety, ESRD on PD, depression, T1DM, HTN, GERD, gastroparesis, s/p kidney + pancreas transplant. Presented at the time of admission on 8/22 with shortness of breath and cough. Hospital course described: Septic shock 2/2 MRSA bacteremia: In setting of immunosuppression (cyclosporine). Growth of staph aureus on 8/22 and 8/23 cultures. MecA positive. Treated with vancomycin, meropenem, caspofungin, tobramycin. Clindamycin added 8/24. Respiratory failure thought secondary to COVID ARDS with potential bacterial pneumonia superimposed. Initially satting to 96% on RA, with quick increase in oxygen requirement overnight 8/22-8/23. Intubated and transferred to the MICU. CT PE without PE, but with bilateral pneumonia and findings concerning for necrosis in LLL and some cavitation medially in the right lung, possibly abscess formation. Concerning for development of an aspiration PNE. Treated with Remdesivir and Dexamethasone. CRRT for volume removal. Severe metabolic and respiratory acidosis: Gap (lactate) and non-gap (renal dysfunction) contributions. Thought secondary to septic shock and renal failure in setting of missed dialysis and acute infection. Required concentrated bicarb drip. She was also hypoglycemic as low as 37 treated with Dextrose infusion. She developed atrial fibrillation with rapid ventricular response evening of 8/24 with HR increased to 180s. This was treated with amiodarone bolus + drip as well as fluid resuscitation. HR responded to interventions however she remained hypotensive requiring addition of phenylephrine to her pressors. She required phenylephrine, levophed, and vasopressin for much of the evening as well as albumin, LR, bicarb pushes, and increasing rates of dextrose infusion. Transitioned patient to comfort care evening of 8/24. Palliative extubation performed that evening and all life sustaining medications were withdrawn. Patient was pronounced dead 8/24 at 2339.


VAERS ID: 1727109 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-15
Onset:2021-08-07
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Acute respiratory failure, Anticoagulant therapy, Blood fibrinogen, Blood gases, Blood lactate dehydrogenase, Blood magnesium, Bradycardia, C-reactive protein, COVID-19, COVID-19 pneumonia, Cardiac arrest, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Death, Dyspnoea, Endotracheal intubation, Fibrin D dimer increased, Full blood count, Heart rate irregular, Hyperhidrosis, Liver function test, Metabolic function test, Pneumonia bacterial, Positive airway pressure therapy, Positive end-expiratory pressure, Prothrombin time, Resuscitation, Sepsis, Serum ferritin, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), 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 (narrow), 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), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-10
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hypertension medications
Current Illness: unknown
Preexisting Conditions: morbid obesity, HTN,
Allergies: No known drug allergies
Diagnostic Lab Data: CBC, CMP, PT, PTT, D DIMER, ABG''S, FIBRINOGEN, LFT, MAGNESIUM, LDH, FERRITIN, CRP. Labs concurrent with COVID pneumonia, sepsis, respiratory failure. CT, XRay chest done to assess lung status daily, continues to be concurrent with COVID pneumonia diminishing over stay.
CDC Split Type:

Write-up: obese 35yoM who presents with acute SOB which was found in the ED due to acute COVID 19. He is diaphoretic, and speaks in only short sentences, frequently expressing varying preference for BPAP or facemask. He received the Moderna vaccine series several months prior, and had been in his usual state of good health prior to the abrupt onset of symptoms. He takes medication for hypertension. DISCHARGE DIAGNOSIS: 1. Acute hypoxic respiratory failure secondary to COVID- 19 pneumonia 2. COVID- 19 pneumonia with super-imposed bacterial pneumonia 3. Sepsis secondary to above on pressor support 4. Obesity with body mass index 57 5. Elevated D-dimer He was started on NRB and BPAP, as well as all COVID therapies of steroids, anticoagulation, Colchicine, and Ivermectin. He was also started on broad spectrum antibiotics for possible super-imposed bacterial pneumonia. His oxygenation worsened and he was intubated on 8/8. His O2 levels remained difficult to control and the AM of 8/9 he was proned with increasing PEEP. His oxygenation improved and he appeared to be overall stabilizing by 8/10. The afternoon of 8/10, he was getting suctioned by RT and was noted to become bradycardic, however, this quickly resolved with Atropine and was attributed to increased vasovagal tone secondary to prone positioning and increased PEEP. He remained HD stable and his O2 remained 90s (Last recorded VS HR 61, RR 24, BP 111/67, and O2 99%). Unfortunately, at approximately 2117 the patient developed an irregular heart rate before going into ventricular tachycardia and then asystole. He was started on medical management as per guidelines and CPR was initiated as soon as possible under the direction of Dr. was never obtained and Dr called at 2150. The patient''s family was informed of his passing and all questions were answered. Cause of death appears to be cardiac arrest secondary to ventricular tachycardia secondary to hypoxic respiratory failure secondary to COVID- 19 pneumonia.


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https://medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=FRM&GROUP2=VACD&GROUP3=MAN&GROUP4=AGE&GROUP5=DEAD&EVENTS=ON&PERPAGE=50&SYMPTOMS=Death+%2810011906%29&VAX=COVID19&VAXTYPES=COVID-19&VAXCNT=2&VAXMAN=PFIZER/BIONTECH&DIED=Yes&AGES[]=7&AGES[]=8&AGES[]=9&DEATH_YEAR_LOW=2019&DEATH_YEAR_HIGH=2021

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