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From the 1/14/2022 release of VAERS data:

Found 52 cases where Age is 12-or-more-and-under-17 and Vaccine is COVID19 and Patient Died

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Case Details

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VAERS ID: 1823671 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-10-13
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-13
   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: USPFIZER INC202101426032

Write-up: death; This is a spontaneous report from a contactable consumer. A 16-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE 2, SINGLE at the age of 16-year-old for covid-19 immunisation. The patient medical history and concomitant medications were not reported. patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 13Jul2021 at the age of 16-year-old for covid-19 immunization. The patient experienced death on 13Oct2021. The patient died on 13Oct2021. The lot number for vaccine (BNT162B2), was not provided and will be requested during follow-up; Reported Cause(s) of Death: death


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

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

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

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


VAERS ID: 1865389 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-09
Onset:2021-11-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Cardiac dysfunction, Chemotherapy, Death, Electrocardiogram Q waves, Electrocardiogram T wave peaked, Heart rate increased, Hypoxia, Livedo reticularis, Mechanical ventilation, Multiple organ dysfunction syndrome, Oxygen saturation decreased, Poor peripheral circulation, Pulmonary haemorrhage, Resuscitation, Thrombocytopenia
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (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), Malignancy related therapeutic and diagnostic procedures (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), Dehydration (broad), Sepsis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bactrim, dexamethasone, Ketorolac, Vanc, sodium chloride
Current Illness: ALL, hypertension, obesity, Type 2 Diabetes, Cdiff
Preexisting Conditions: ALL phase DI of treatment, hypertension, Diabetes, obesity
Allergies: NKA
Diagnostic Lab Data: Pt expired 11/11/21 (Continued) despite vasopressor support. She was given a dose of bicarbonate with some brief improvement in saturations to 70s and increased heart rate but subsequently became asystolic and CPR was started. She was given epi x 2 doses as well as a dose of bicarbonate and was hand ventilated; there was significant blood backing up into her ETT. Parents at the bedside requested cessation of resuscitation efforts at that point and the patient was pronounced dead at 2036 on 11/11/21. The doctor of the heme/onc service made aware of the patient''s death; she had been at the bedside earlier in the day and involved with the conversations regarding the patient''s decline.
CDC Split Type:

Write-up: Patient with progressive hypoxemia throughout the day despite multiple changes in ventilator settings/modes. HFOV discussed with family, but functional oscillator not available and was awaiting arrival of donor oscillator. She is not a candidate for ECMO due to pulmonary hemorrhage and thrombocytopenia with recent chemotherapy as well as BMI (morbidly obese). Trial on nitric oxide performed with minimal improvement (sats increased from 60% to 65-68%). She was noted to have increasing peaked T waves as well as development of Q waves concerning for hyperkalemia and worsening cardiac function consistent with multiorgan failure; perfusion was quite poor with mottled extremities and difficult to palpate central pulse


VAERS ID: 1913198 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-09-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Airway peak pressure increased, Asthenia, Back pain, Bradycardia, Cardiac output decreased, Cardiac tamponade, Chemotherapy, Chest pain, Death, Debridement, Diarrhoea, Dyspnoea, Endotracheal intubation, Epithelioid sarcoma, Exploratory operation, Fatigue, Fluid retention, General symptom, Haemofiltration, Hypotension, Influenza virus test negative, Intracardiac mass, Lactic acidosis, Loss of personal independence in daily activities, Low lung compliance, Multiple organ dysfunction syndrome, Neoplasm malignant, Oedema, Oropharyngeal pain, Pericardial excision, Pericardial rub, Pneumonia, Pulmonary oedema, Pyrexia, SARS-CoV-2 test negative, Sedation, Streptococcus test negative, Tachycardia, Tumour excision
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), 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) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-12-01
   Days after onset: 91
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 30 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None known
Current Illness: unknown
Preexisting Conditions: none
Allergies: No known allergies
Diagnostic Lab Data: Admitted to local HCF 10/30/21. See the following from her death note summary related to hospital course: Pt is a 13 y.o. female admitted for Left atrial mass and has been hospitalized for 30 days. she had her left atrial mass resection on 11/11/21, pericardial window creation, and mediastinal exploration with debridement. Her mass continued to grow and increase in size and Rhee invading the left atrium and possibly the right atrium along with creation of tamponade physiology on the ventricles. She was started on chemotherapy by hematology team, Nephrology team started her her on CRRT since she developed acute kidney injury along was multi organ failure and severe lactic acidosis. Patient was on multiple inotropics support with progressively increasing inotropics support epinephrine up to 0.3 micrograms/kilogram per minute, norepinephrine up to 0.3 micrograms/kilogram per minute along with 2 milliunits per kg per minute vasopressin. Over the past 48 hours prior to patient staff she was getting multiple fluid boluses and she was few L positive every day with severe 3rd spacing and progressively worsening cardiac output. She has had evidence of progressive tamponade physiology despite aggressive chemotherapy. she remained intubated and sedated with extremely high lung peak pressures and very poor compliance with severe pulmonary edema. On 12/1/2021 family expressed the wishes of stop giving fluids to her since she looks very edematous, parents understand that this will lead to cardiac arrest and ending her life within the next few hours, father expressed he is willing to do everything for her but he wants to end her suffering, mom and dad were at the bedside, IV fluid replacement was stopped. Patient vasopressin was weaned along with other inotropic support, family agreed on extubating the patient so that they can spend some time with her prior to the off. Patient continue to progressively having low cardiac output, hypotension and bradycardia, time of death was 7:00 a.m..
CDC Split Type:

Write-up: Patient received Pfizer vaccine in 8/2021. In 9/2021 she began to have some vague complaints of upper back pain. Patient ultimately diagnosed with epitheliod sarcoma. Parents requested that this information be sent to VAERS in case her cancer was related to Vaccine. Physicians caring for the child do not feel her death or her cancer was related to the covid vaccine. Presented to the local Medical Center on 10/30/21 after having received care closer to home. Pt is a 13 y.o. female with no past medical history who presents with fever, chest pain, and diarrhea. About two weeks PTA, she began complaining of sternal chest pain. She had fatigue and sore throat so was taken to an urgent care where she was negative for strep, flu, and COVID. She was prescribed bromfed. She then progressed to a dry mild that started about 10 days PTA. On Tuesday, 10/26, she was seen at an outside ER and was diagnosed with pneumonia. She was started on azithromycin and augmentin. She has continued to have chest pain, SOB, and fatigue. The day of presentation, she stayed home from school. She developed nonbloody diarrhea, tachycardia, and weakness so she was taken back to the ER for evaluation. Found to have a pericardial friction rub. Admitted to hospitalist service.


VAERS ID: 1963633 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-19
Onset:2021-12-02
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Alpha haemolytic streptococcal infection, Angiogram cerebral abnormal, Arterial catheterisation, Arterial spasm, Asthenia, Blood culture positive, Brain injury, COVID-19, Central venous catheterisation, Cerebral endovascular aneurysm repair, Cerebral haemorrhage, Cerebral mass effect, Cognitive disorder, Computerised tomogram head abnormal, Death, Decompressive craniectomy, Drug titration, Echocardiogram abnormal, Ejection fraction decreased, Electroencephalogram normal, Endotracheal intubation, Extubation, Gait inability, Gastrointestinal tube insertion, Headache, Heart rate decreased, Hypophagia, Hypotension, Infusion, Intensive care, Intracranial pressure increased, Intraventricular haemorrhage, Laboratory test abnormal, Left ventricular dysfunction, Magnetic resonance imaging head abnormal, Mechanical ventilation, Medical induction of coma, Mydriasis, Myocardial stunning, Pain, Personality change, Positive airway pressure therapy, Posturing, Pulmonary oedema, Pupillary light reflex tests abnormal, Pyrexia, Ruptured cerebral aneurysm, SARS-CoV-2 test positive, Seizure, Subarachnoid haemorrhage, Syncope, Ultrasound scan, Urine output increased, Ventricular drainage, Ventricular hypokinesia
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (narrow), Cardiomyopathy (narrow), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-12-19
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: None
Allergies: No known allergies.
Diagnostic Lab Data: Head CT, MRI, Echocardiogram, multiple ultrasounds, angiogram
CDC Split Type:

Write-up: In brief, patient is a previously healthy 15 year old who had acute headache and collapse at home, concern for posturing versus seizure, and ultimately found to have cerebral and intraventricular hemorrhage with mass effect secondary to ruptured aneurysm. S/p coiling of aneurysm, bilateral EVD placement and R decompressive craniectomy. She has acute respiratory failure, strep viridans bacteremia, and concurrent COVID-19 infection. Presented 12/2/21 with aneurysm and incidentally found to be COVID positive. NEURO: On arrival, she was somewhat responsive and by the time she arrived at ED she was posturing versus seizing. Head CT revealed hemorrhage 3x3x3 hemorrhagic focus anterior and inferior to the right basal ganglion with mass effect, also with intraventricular blood in lateral and third ventricles with acute subarachnoid hemorrhage in suprasellar cistern and bilateral sylvian fissures. At that time, reportedly pupils equal, 3-4, minimally reactive. At ED, received Mannitol bolus, and 4mg Ativan administered. Flight for Life activated and upon arrival to CW was admitted to the PICU with plan for emergent EVD placement. Neurosurgery placed EVD at bedside. Repeat head CT and CTA performed and demonstrated bilobed aneurysm arising from right ICA terminus with enlarging intraparenchymal hematoma along superior aspect mostly likely representing a ruptured aneurysm, increased intraventricular hemorrhage, similar subarachnoid hemorrhage, increased mass effect, effacement of basal cisterns, worsened midline shift. Optimized neuroprotection management with sedation, neuromuscular blockade, ventilator management, and hypertonic saline. R pupil became dilated and nonreactive and patient demonstrated persistently elevated ICPs $g50. She underwent emergent IR coiling and R decompressive craniectomy with second right-sided EVD placement. Patient continued to demonstrate ICPs in 20s. Worked with Neurosurgery to optimize sedation. Repeat head CT demonstrated increased hypoattenuation in right frontal and parietal lobes, left parietal lobe, and splenium of corpus callosum. Loss of gray-white differentiation concerning for ischemic change. Increased right to left midline shift. TCDs demonstrated moderate spasm of the L MCA. EEG without seizure. Started Pentobarbital coma. On 12/9, an occurred episode while in transport to MRI and patient was noted to be obtunded. ICP 11 during episode, EVDs patent. She was not connected to LTM during episode, as she was in transport. She was started on epi drip and became more responsive, moving spontaneously and withdrawing to pain. On 12/10, her neurostorming medication regimen was optimized and no further changes were made. Given poor neurologic prognosis, patient was given adequate sedation for pain management during terminal extubation on 12/18. CV: Had periods of hypotension intraoperatively requiring initiation of Epinephrine and Norepinephrine infusions to maintain goal MAP $g 80, SBP $g 120. Returned to PICU with femoral CVL, arterial line, sedated with Fentanyl and Dexmedetomidine infusions, and on Vecuronium infusions, Nimodipine. On 12/4 echocardiogram report noted significant for left ventricular mid-inferoseptal hypokinesis and moderately diminished left ventricular systolic function, with an LVEF 41%. She required titration of pressors to maintain goal pressures. Added stress dose Hydrocortisone. Repeat echocardiogram demonstrated significant improvement in LV systolic function, consistent with the hypothesis that myocardium was neurologically stunned. 12/6-12/8 Patient weaned from sedation and pressors. On 12/9 she experienced a hypotensive episode while in transport to MRI. HR dropped to 40s-50s. 105 mcg Epi dwindle given, then started on Epi drip, given 500 mL NS push pull. HR and BP normalized. On 12/10, patient was weaned from pressors and stress dose steroids. She remained hemodynamically appropriate leading to terminal extubation on 12/18. RESP: Intubated in the OR. Notably, course complicated by significant pulmonary edema with poor compliance. On 12/10, her ventilator settings were weaned to CPAP/PS. She remained hemodynamically appropriate with CPAP/PS until terminal extubation on 12/18. FEN/GI: On 12/10 patient was started on enteral feeds which were discontinued after terminal extubation on 12/18. ID: At ED, she was incidentally found to be COVID positive. Blood cultures were drawn at that time positive for strep viridans. She started on empiric Cefepime and Vancomycin due to concern for septic shock given pressor requirements. Initiated thermoregulation. Patient continued to be intermittently febrile and remained on Ceftriaxone per family''s wishes until 12/19. RENAL: Initially had significantly increased urine output. Labs concerning for DI, although could also be secondary to 3% boluses. Initiated DI protocol. This later resolved and she continued to have urine output appropriate for age leading to her terminal extubation on 12/18. OTHER: On 12/5 ,discussion took place between provider and mother and placed partial code status, including no bolus cardiac resuscitative medications, no defibrillation, no chest compressions. Care Conference took place on 12/10, during which mother voiced she would like to get MRI for further neuroprognostication before changing goals of care. Care conference on 12/14 to discuss MRI results with family. Neurology explained likely deficits patient will experience as a result of her brain injury including weakness of both sides of her body, inability to walk, inability to effectively eat PO, personality changes, cognitive dysfunction. Mother voices "Patient would not want to live like this," but requests time to discuss these options with family before making any decisions. Another discussion between providers and family on 12/15 during which family voiced they would not want patient to be reintubated once extubated, would not want her to receive blood products, and would like to continue with enteral feeding. Tentative plans for extubation on 12/17 or 12/18 once family from out of state has come to say their goodbyes. Family later decided to move forward with terminal extubation on 12/18. She was extubated 12/18 to room air and passed away on 12/19/2021 @ 20:37 PM with mother, brother and step father at the bedside.


VAERS ID: 1974744 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-17
Onset:2021-12-11
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 UN / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 UN / -

Administered by: Private       Purchased by: ?
Symptoms: Air embolism, Autopsy, Death, Toxicologic test
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-12-11
   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: Latuda, Wellbutrin, Topiramate, Gabapentin, Metformin
Current Illness: None.
Preexisting Conditions: Bipolar
Allergies: None.
Diagnostic Lab Data: Autopsy conducted through the Medical Examiner, pending final toxicology results.
CDC Split Type:

Write-up: Patient passed away on 12/11/21 at 12:11pm from bilateral pulmonary emboli (air bubbles not DVT). Final autopsy results pending toxicology results.


VAERS ID: 1576798 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-15
Onset:2021-07-23
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0583 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Completed suicide
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD; Self injurious behaviour
Allergies:
Diagnostic Lab Data: Test Date: 20210715; Test Name: Body temperature; Result Unstructured Data: Test Result:36.2; Comments: Before vaccination
CDC Split Type: JPPFIZER INC202101008056

Write-up: Suicide; This is a spontaneous report from a contactable physician received from the Regulatory Authority. Regulatory authority report number is v21122543. The 16-year and 5-month-old male patient received first dose of bnt162b2 (COMIRNATY) at 16-year-old on 15-JUL-2021 12:00 as dose 1, single (lot number: EY0583, expiration date: 31Oct2021) for COVID-19 immunisation. Body temperature before vaccination was 36.2 degrees Centigrade. Medical history included attention deficit hyperactivity disorder (ADHD) and Self injurious behaviour. Concomitant medications and family history were not provided. The course of the events was as follows: On 15Jul2021 at 12:00 (the day of vaccination), the patient received the first dose of BNT162b2 (COMIRNATY, Solution for injection, Lot# EY0583, Expiration date 31Oct2021) via an unspecified route of administration as a single dose for COVID-19 immunization. On 23Jul2021 at 18:30 (8 days after the vaccination), the patient experienced suicide and died. The outcome of the event was fatal. It was not reported if an autopsy was performed. The course of the event was as follows: On 23Jul2021, the patient jumped off the top floor of the apartment and died. It was assumed the he killed himself. The reporting physician classified the event as serious (fatal) and assessed that the event was not related to BNT162b2. Other possible cause of the event such as any other diseases was ADHD. The reporting physician commented as follows: The patient was prescribed oral medicines for ADHD at a psychiatry department, but recently he had stopped taking them, and self injurious behaviour had been noted.; Sender''s Comments: Event suicide represents an intercurrent medical condition and unrelated to bnt162b2 . The underlying history of attention deficit hyperactivity disorder (ADHD) and Self injurious behavior may play a explanation.; Reported Cause(s) of Death: Suicide


VAERS ID: 1592684 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-11
Onset:2021-07-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Body temperature decreased, Brain death, Brain hypoxia, C-reactive protein, Cardiac arrest, Coma, Computerised tomogram, Computerised tomogram head, Echocardiogram, Electrocardiogram, Electroencephalogram, Full blood count, Headache, Magnetic resonance imaging, Pain in extremity, SARS-CoV-2 antibody test positive, Ultrasound Doppler
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), Ischaemic central nervous system vascular conditions (narrow), 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), Hypertension (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-07
   Days after onset: 27
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Barlow''s syndrome; Marfan''s syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210713; Test Name: arterial pressure; Result Unstructured Data: Test Result:90/60 mmHg; Test Date: 20210713; Test Name: temperature control; Result Unstructured Data: Test Result:36 Centigrade; Test Date: 20210713; Test Name: CT scan; Result Unstructured Data: Test Result:The ascending aorta is moderately dilated; Comments: No aortic dissection or large vsx, no intracranial bleeding, the super sigmoid aortography does not show any aortic insufficiency; Test Date: 20210715; Test Name: CT scan; Result Unstructured Data: Test Result:appearance of parenchymal parenchymal hemispherica; Comments: appearance of parenchymal parenchymal hemispherical hemispherical right upper cerebellar areas of ischemic appearance; Test Date: 20210713; Test Name: brain CT scan; Result Unstructured Data: Test Result:no bleeding; Comments: no traumatic injury; Test Date: 20210723; Test Name: brain CT scan; Result Unstructured Data: Test Result:stability of ischemic; Comments: lesions appearance of cerebral edema compatible with anoxo-ischemic lesions, put under Mannitol; Test Date: 20210727; Test Name: brain CT scan; Result Unstructured Data: Test Result:increase in cerebral edema; Comments: reaching almost the entire sustentorial stage, sudden episodes of desaturation.; Test Date: 20210713; Test Name: C-reactive protein; Result Unstructured Data: Test Result:1.4; Test Name: Trans-thoracic echocardiography; Result Unstructured Data: Test Result:finding a 30%; Comments: altered left ventricular ejection fraction with kinetic disorders suggestive of Takotsubo; Test Date: 20210713; Test Name: Electrocardiography; Result Unstructured Data: Test Result:Not very evocative; Comments: Respiratory rate; Test Date: 20210723; Test Name: electroencephalogram; Result Unstructured Data: Test Result:flat; Comments: with a few waves of intermittent activity; Test Date: 20210727; Test Name: electroencephalogram; Result Unstructured Data: Test Result:Pathological; Comments: Keppra introduction; Test Date: 20210713; Test Name: complete blood count; Result Unstructured Data: Test Result:normal; Test Date: 20210713; Test Name: cardiac magnetic resonance imaging; Result Unstructured Data: Test Result:cardio; Comments: in favor of a takotsubo; Test Date: 20210713; Test Name: covid; Test Result: Positive ; Comments: (Ig G antiS and antiN and IgM), re-reading of the entry serology concluded with a Covid infection starting at the same time as the anti-covid vaccination; Test Date: 20210713; Test Name: Left transcranial doppler; Result Unstructured Data: Test Result:left more disturbed; Comments: than the right (Vdiastolic 20 vs 40 on the right)
CDC Split Type: FRPFIZER INC202101056242

Write-up: This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB [FR-AFSSAPS-MP20215396]. A 15-year-old female patient received bnt162b2 (COMIRNATY), intramuscular on 11Jul2021 07:30 (Lot Number: Unknown) (at the age of 15-year-old) as dose 1, single for COVID-19 immunization. Medical history included ongoing asthma, ongoing Barlow''s syndrome, ongoing Marfan''s syndrome. The patient''s concomitant medications were not reported. In good health overall, apart from a loss of 10kg over one year (since entering high school). During the day (11Jul2021), asthenia and isolated arm pain. The next day (12Jul2021), headaches yielding under Doliprane. On 13Jul2021, around 16:30 (last moment conscious view), her mother drops her off to her father. Father watered the garden and she cleaned the garage to prepare for her birthday party. On 13Jul2021 17:20, her father found her in cardio respiratory arrest, back to the ground, next to a ladder. No flow was unknown. At 17:30 arrival of firefighters: 2 external electric shocks were given and 1 mg of adrenaline injected. Moderately reactive pupils. At 17:50 arrival of Specialist mobile emergency unit: asystole (Life-threatening). Two injections of 1 mg of adrenaline, transition to ventricular fibrillation. 2 external electric shock, 2 ampule of Cordarone and one ampule of Calcium Gluconate. Return to regular sinus rythme without disturbance of repolarization and resumption of a pulse. Orotracheal intubation (probe no 6). New: 1 external electric shock, one ampule of Cordarone and 1 mg of adrenaline. Return of a sinus rhythm but presence of a sub ST in infero lateral. 90/60 mmHg arterial pressure excluding sedation. Tight areactive bilateral miosis pupils. Ventilated in Ventilator-Associated Conditions but presence of spontaneous ventilation requiring sedation by Hypnovel and Sufentanyl and 10 mg of Nimbex. Parallel introduction of Noradrenaline 0.8 mg/h. No filling. In total: low flow of 30 minutes. Recovered and transfer to intensive care. Examinations: biology: complete blood count normal, C-reactive protein 1.4. Coroner considered as normal no coronary dissection. Computed tomography scan Computed tomography arterial portography: No aortic dissection or large vsx, no intracranial bleeding, the super sigmoid aortography does not show any aortic insufficiency. The ascending aorta is moderately dilated. Computerised tomogram head: no bleeding, no traumatic injury. Electrocardiogram: Not very evocative. Respiratory rate. Maintenance of sedation, temperature control at 36 degrees. Complicated cardiac arrest of a Takotsubo. Trans-thoracic echocardiography finding a 30% altered left ventricular ejection fraction with kinetic disorders suggestive of Takotsubo (post stress?). More doubt about intra-left ventricular thrombus. Low left ventricular filling pressures. Integral time speed= 8. Inferior vena cava= 15. 15Jul2021 Appearance in the morning of continual clonies of the multiple sulfatase deficiency, put under Keppra increased to 750x2. Electroencephalography results pending + Left transcranial doppler more disturbed than the right (Vdiastolic 20 vs 40 on the right), Control contrast enhanced computed tomography scan superimposable at the level of large vsx, but appearance of parenchymal parenchymal hemispherical hemispherical right upper cerebellar areas of ischemic appearance. 20Jul2021 pathological awakening, inhalation lung disease, myocarditis assessment in progress (negative). 23Jul2021 no sign of wakign up flat electroencephalogram alternating with a few waves of intermittent activity. Computered tomography scan stability of ischemic lesions appearance of cerebral edema compatible with anoxo-ischemic lesions, put under Mannitol. Cardio: cardiac magnetic resonance imaging in favor of a takotsubo, myocarditis unlikely, infective and immunological workup negative. 27Jul2021 Pathological electroencephalogram, Keppra introduction. Computered tomography scan increase in cerebral edema reaching almost the entire sustentorial stage, sudden episodes of desaturation. The COVID serology returns positive (Ig G antiS and antiN and IgM), re-reading of the entry serology concluded with a Covid infection starting at the same time as the anti-covid vaccination. 30Jul2021 retro-rolandic aspect of brain death, vegetative coma. Decision to limit therapy. Complete file no further information. The patient died on 07Aug2021. An autopsy was not performed. Cause of Death: Anoxia cerebral and Cardiac arrest while outcome of the other events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Cardiac arrest; Anoxia cerebral


VAERS ID: 1633205 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 10020A / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Disseminated intravascular coagulation, International normalised ratio, Multiple organ dysfunction syndrome, N-terminal prohormone brain natriuretic peptide, Platelet count, Prothrombin time, Pulmonary haemorrhage, Pyrexia, Septic shock, Troponin T
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-14
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dysphagia; Extremely preterm (less than 28 weeks); Hypoxic-ischaemic encephalopathy; Posthaemorrhagic hydrocephalus; Reflux oesophagitis; Respiratory insufficiency; Symptomatic epilepsy
Allergies:
Diagnostic Lab Data: Test Name: pTT; Result Unstructured Data: Test Result:$g180 seconds; Test Name: INR; Result Unstructured Data: Test Result:4.9; Test Name: proBNP; Result Unstructured Data: Test Result:24937 pg/mL; Test Name: Platelets; Result Unstructured Data: Test Result:min 3410x31uml; Test Name: Quick; Result Unstructured Data: Test Result:<10; Test Name: Troponin T; Result Unstructured Data: Test Result:1580 pg/mL
CDC Split Type: DEPFIZER INC202101072828

Write-up: Disseminated intravascular coagulation; Lung hemorrhage; Pyrexia; Multiorgan failure; Septic shock; This is a spontaneous report from a non-contactable other HCP. DE-PEI-202100168078. A 13-yars-old male patient received bnt162b2 (COMIRNATY, Formulation: Solution for Injection, Batch/Lot Number: 10020A) dose 2 0.3 mL via an unknown route of administration on 11Aug2021 (at the age of 13-years-old) as dose 1, single for COVID-19 immunisation. The patient''s medical history included extremely preterm (less than 28 weeks), Hypoxic-ischaemic encephalopathy, posthaemorrhagic hydrocephalus, symptomatic epilepsy, dysphagia, respiratory insufficiency, reflux oesophagitis on an unspecified date. The patient previously received first dose of bnt162b2 (COMIRNATY, Formulation: Solution for Injection) dose 1, Batch/Lot number unknown) for COVID-19 immunisation on 16Jun2021. Concomitant medications were not reported. The patient underwent lab tests and procedures which included platelets min 3410x 31uml, Quick <10, INR$g4.9, pTT $g180 sec, proBNP 24937 pg/ml, Trop T 1580 pg/ml on an unknown date. The patient experienced multiorgan failure, lung hemorrhage, disseminated intravascular coagulation, pyrexia and septic shock on 13Aug2021. The patient died due to Unknown cause of death on 14Aug2021. Seriousness for the events was reported as death, hospitallization and life threatening. The autopsy details were not reported. Sender Comment: Platelets min 3410^31uml, Quick <10, INR$g4,9; pTT $g180 sec, proBNP 24937 pg/ml, Trop T 1580 pg/ml Relatedness of drug to reaction(s)/event (s) Result of Assessment D. Unclassifiable No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1668800 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2154 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-13
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JOPFIZER INC202101119141

Write-up: Death/passed away; This is a spontaneous report from a contactable consumer or other non HCP (parent, father of patient). A 15-year-old male patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in the left arm on 09Aug2021 at 09:00 AM (at the age of 15-year-old; lot number: FF2154) as DOSE 1, SINGLE for COVID-19 immunisation. The patient''s medical history and concomitant medications were not provided. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The father reported that the patient (the son) received the dose 1 of the Pfizer vaccine on 09Aug2021 at 9AM on left arm. Unfortunately, patient passed away (death) on Friday 13Aug2021 at 04:30 without any history of illness. The event resulted in Emergency room/department or urgent care. Prior to vaccination, patient did not diagnose with COVID-19. Since the vaccination, patient did not test for COVID-19. Device date was 29Aug2021. No treatment received. Outcome of the event was fatal. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: Death/passed away


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