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From the 7/16/2021 release of VAERS data:

Found 11,405 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 235 out of 1,141

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VAERS ID: 1145320 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cyanosis, Death, Pulse absent, Unresponsive to stimuli, Wheelchair user
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (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), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vantin, trazadone, aricept, senna, ertapenem, vitamin D, heparin, risperidone,
Current Illness: Urosepsis with metabolic encephalopathy
Preexisting Conditions: Hyperlipidemia, right breast carcinoma, Alzheimer''s diease with dementia, atherosclerosis of aorta, right exudative age related macular degeneration.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient reviewed vaccination at 1:20pm. She was observed for one hour per MD. At 5:18, she became unresponsive in her wheelchair and became blue with no palpable pulse. Patient had a DNR status and was not revived.


VAERS ID: 1145423 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-12
Onset:2021-03-26
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase normal, Bacterial test positive, Basophil count normal, Basophil percentage, Bilirubin urine, Bladder catheterisation, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood chloride normal, Blood creatine increased, Blood glucose normal, Blood magnesium increased, Blood potassium normal, Blood sodium normal, Blood urea increased, Blood urine present, Brain natriuretic peptide, C-reactive protein normal, Carbon dioxide normal, Cardiomegaly, Chest X-ray abnormal, Chromaturia, Culture urine, Culture urine positive, Death, Differential white blood cell count abnormal, Eosinophil count normal, Eosinophil percentage decreased, Escherichia infection, Full blood count abnormal, Glomerular filtration rate decreased, Glucose urine absent, Haematocrit decreased, Haemoglobin decreased, Immature granulocyte count increased, Immature granulocyte percentage increased, International normalised ratio normal, Lymphocyte count, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume increased, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count increased, Monocyte percentage, Myocardial infarction, Neutrophil count increased, Neutrophil percentage increased, Nitrite urine present, Platelet count increased, Pleural effusion, Protein total normal, Protein urine present, Prothrombin time normal, Red blood cell count decreased, Red blood cell nucleated morphology, Red cell distribution width increased, SARS-CoV-2 test negative, Serum ferritin increased, Specific gravity urine normal, Troponin I increased, Urine ketone body absent, Urine leukocyte esterase positive, Urobilinogen urine, White blood cell count increased, White blood cells urine positive, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: See VAERS Report #322299
Other Medications: Acetaminophen 500mg Oral EVERY 6 HOURS PRN amLODIPine Besylate 10 MG TAKE ONE (1) TABLET BY MOUTH ONCE DAILY Aspirin 81 mg Oral DAILY Blood Glucose Monitoring Suppl w/Device Use when testing blood sugars one time each day. Dx: E11.9 cl
Current Illness:
Preexisting Conditions:
Allergies: Ambien crestor macrodantin penicillin Plavix probenecid statins
Diagnostic Lab Data: Urine culture Collected: 03/26/21 1049 Order Status: Completed specimen: URINE,CLEAN CATCH (CCMS) Updated: 03/28/21 0840 Specimen Type CCMS Special Handling NONE Reflexed from F57974 Culture Result $g=100,000 COL/ML ESCHERICHIA COLI Specimen Status Report 03/28/2021 FINAL Organism Identification ESCHERICHIA COLI Susceptibility Escherichia coli MIC Amoxicillin/clavulanate Sensitive Ampicillin Resistant Ampicillin/sulbactam Resistant Aztreonam Sensitive Cefazolin Sensitive1 Cefepime Sensitive Cefoxitin Sensitive Ceftazidime Sensitive Ceftriaxone Sensitive Cefuroxime Sensitive Ciprofloxacin Resistant Ertapenem Sensitive Gentamicin Sensitive Imipenem Sensitive Levofloxacin Resistant Nitrofurantoin Sensitive Piperacillin/Tazob Sensitive Tetracycline Resistant TMP SULFA Resistant Tobramycin Sensitive 1 SUSCEPTIBL Linear View Susceptibility Comments Escherichia coli $g=100,000 COL/ML ESCHERICHIA COLI Ferritin [245923475] (Abnormal) Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/28/21 0200 Ferritin --High 18 - 340 ng/mL 585 (NOTE) High C-reactive protein [245923474] Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/27/21 1557 CRP -- 0.0 - 0.8 mg/dL 0.5 (NOTE) INTERPRETIVE INFORMATION: C-Reactive Protein Significantly decreased CRP values may result in specimens from patients treated with carboxypenicillins. NOVEL CORONAVIRUS SARS-COV-2 BY PCR [245923473] Collected: 03/26/21 1049 Order Status: Completed Specimen: Nasopharyngeal Updated: 03/27/21 1358 SARS-COV-2 Source NASOPHARYNGEAL SARS-COV-2 By PCR Not Detected Not Detected Comment: THIS TEST HAS BEEN VALIDATED BUT FDA''S INDEPENDENT REVIEW OF THE VALIDATION IS PENDING. THIS TEST IS PERFORMED AS A LABORATORY DEVELOPED TEST, INDEPENDENT REVIEW OF THE VALIDATION UNDER THE FDA''S EMERGENCY USE AUTHORIZATION (EUA) AUTHORITY WILL BE PERFORMED ACCORDING TO CURRENT GUIDANCE REQUIREMENTS. ********** WE WILL CONTINUE TO FOLLOW FEDERAL AND STATE REQUIREMENTS FOR BOTH NOTIFICATION OF RESULTS AND ANY CONFIRMATORY TESTING FHC COVID Antigen [245923485] Collected: 03/26/21 1050Order Status: Completed Specimen: NARES from NASAL Updated: 03/26/21 1114 FHC COV AG PRESUMPTIVE NEGATIVE Urinalysis with reflex to culture, if indicated [245923471] (Abnormal) Collected: 03/26/21 1049 Order Status: Completed Specimen: URINE, CATH IN AND OUT Updated: 03/26/21 1103 Glucose UA NEGATIVE NEGATIVE MG/D Protein UA TRACE Abnormal NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA 0.20.2 - 1.0 MG/DL pH UA 6.5 5.0 - 8.0 Blood UA TRACEAbnormal NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA POSITIVEAbnormal NEGATIVE Leukocyte Esterase UA 2+Abnormal NEGATIVE UR Appearance CLEAR CLEAR Specific Gravity UA 1.020 1.000 - 1.030 Color YELLOW YELLOW Site VOIDEDComment, Urine Culture IN PROGRESS WBC Urine 51 to 100 <5 /HPF Bacteria MODERATE Abnormal NONE /HPF Magnesium [245923468] Collected: 03/26/21 0907Order Status: Completed Specimen: Blood Updated: 03/26/21 095 Magnesium 2.2 1.8 - 2.4 MG/DLTroponin Series [245923470] (Abnormal) Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0954 Troponin I 0.10High 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel (Abnormal) Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0953 Glucose 148High 65 - 100 MG/DL Blood Urea Nitrogen 40High 7 - 18 MG/DL Creatinine 2.4High 0.5 - 1.0 MG/DL Sodium 140 136 - 145 MMOL/L Potassium 4.0 3.5 - 5.1 MMOL/L Chloride 101 98 - 107 MMOL/L Co2 23 21 - 32 MMOL/L Calcium 9.7 8.5 - 10.1 MG/DL Protein Total 7.4 6.4 - 8.2 G/DL Albumin 3.8 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 44Low 46 - 116 U/L Alt (SGPT) 18 14 - 59 U/L AST(SGOT) 22 15 - 37 U/L Bilirubin, Total 0.4 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 17Low $g90 ML/MIN/1.73sq.m APTT [245923463] Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0951 APTT 29.3 25.4 - 38.4 SEC Protime (Prothrombin Time) [245923469] Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0951 PROTIME 11.6 10.3 - 12.6 SEC INR 1.0 0.9 - 1.1 Comment: Recommended therapeutic ranges or oral anticoagulant is and INR of 2.0 to 3.0. An INR of 2.5 to 3.5 is recommended to prevent recurrent MI. Brain Natriuretic Peptide (BNP) (Abnormal) Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0950 B-Type Natriuretic Peptide 1,210High Panic 0 - 100 PG/ML CBC w Auto Diff [245923465] (Abnormal) Collected: 03/26/21 0907 Order Status: Completed Specimen: Blood Updated: 03/26/21 0922 White Blood Cell Count 15.2High 4.3 - 10.5 THOUS/uL Red Blood Cell Count 3.70Low 3.93 - 5.07 MIL/uL Hemoglobin 11.5Low 11.8 - 14.8 GM/DL Hematocrit 35.9 35.6 - 45.0 % Mean Corpuscular Volume 97.0High 83.5 - 95.9 FL Mean Corpuscular Hemoglobin 31.1 27.4 - 32.0 PG Mean Corpuscular Hemoglobin Conc 32.0 31.5 - 34.7 G/DL Rdwcv 13.7 11.8 - 14.2 % Rdwsd 48.9High 37.2 - 47.8 FL Platelet Count 424High 167 - 402 THOUS/uL Mean Platelet Volume 10.0 8.8 - 12.0 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 79.3High 34.0 - 67.9 % Lymphs 13.2Low 20.4 - 48.6 % Monocytes 5.1 5.0 - 11.5 % Eos 0.8Low 1.0 - 5.4 % Basos 0.7 0.2 - 1.3 % Neutrophils Absolute Count 12.1High 2.1 - 6.6 THOUS/uL Lymphocytes Absolute Count 2.0 1.2 - 3.9 THOUS/uL Monocytes Absolute Count 0.8 0.3 - 0.8 THOUS/uL Eosinophils Absolute Count 0.1 0.1 - 0.4 THOUS/uL Basophils Absolute Count 0.1 0.0 - 0.1 THOUS/uL Imm Gran 0.9High 0.1 - 0.7 % Abs Imm Gran 0.13High 0.0 - 0.1 THOUS/uL XR Chest Portable Collected: 03/26/21 0904 Order Status: Completed Updated: 03/26/21 0914 Narrative: EXAMINATION: Frontal view of the chest CLINICAL HISTORY: 88 years Female,chest pain/cough COMPARISON: 2/18/2021 FINDINGS: The heart is enlarged. There is bilateral hilar haziness and right perihilar infiltrate. Bilateral small effusions. IMPRESSION: Cardiomegaly with bilateral small effusions. Correlate for CHF. Right perihilar infiltrate.
CDC Split Type:

Write-up: 3/26/21 ER to Inpt Admission: Patient was admitted to the hospital for comfort measures after patient suffered MI and did not want any life-prolonging therapies. Patient was started on comfort medications and symptoms were monitored closely. The patient passed peacefully before she could be fully assessed


VAERS ID: 1145434 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Autopsy, Death, Dyspnoea, Resuscitation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-26
   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:
Preexisting Conditions: Coronary Artery Disease, Congestive Heart Failure, Hypertension, Myocardial Infarction, Rheumatoid Arthritis, Osteoarthritis.
Allergies: Unknown.
Diagnostic Lab Data: Autopsy 3/29.
CDC Split Type:

Write-up: Acute onset shortness of breath approximately 11-12 hours post second dose of Moderna covid vaccine. EMS responded and briefly performed CPR before DNR was produced and life saving measures were discontinued. Patient subsequently expired.


VAERS ID: 1145479 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 16B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood gases, Coma scale abnormal, Computerised tomogram, Death, Endotracheal intubation, Extensor plantar response, Full blood count, Haemorrhagic stroke, Liver function test, Metabolic function test, Posturing, Respiratory distress, SARS-CoV-2 test, Tachycardia, Troponin, Unresponsive to stimuli, Urine analysis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-27
   Days after onset: 0
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: Tylenol Calcitonin Calcium Acetate Vitamin B-12 Digestive Aids Mixture OR Multivitamin Preservision AREDS Omega 3 Systane Probiotic Tramadol Kenalog 0.1% Cream
Current Illness: none known
Preexisting Conditions: Hyperlipidemia GERD Osteoporosis Nontraumatic hemorrhage of right cerebral hemishere
Allergies: NKA
Diagnostic Lab Data: CT BMP Hemogram liver panel troponin UA COVID-19 swab Atrial Blood gas
CDC Split Type:

Write-up: Patient received vaccine at 10:18am and then went home with no reaction in the vaccination POD. EMS was called to the patients home shortly before 2:30 that afternoon. When EMS arrived patient was posturing with lower extremities extended in plantar flexion. Last seen normal 30 minutes prior. she was also tachycardic and in respiratory distress with sonorous respirations. Cranial nerve deficit present GCS 3.She was unresponsive and intubated. Airlifted after CT to hospital. She died at 1647 at Hospital from hemorrhagic stroke.


VAERS ID: 1145488 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-25
Onset:2021-03-28
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: congestive heart failure, kidney failure, diabetes
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Death


VAERS ID: 1145508 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-04
Onset:2021-03-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute left ventricular failure, COVID-19, Cardiac failure acute, Cardiomegaly, Death, Dyspnoea, Hypervolaemia, Hyponatraemia, Laboratory test abnormal, Pleural effusion, Pulmonary arterial pressure abnormal, Pulmonary vascular disorder, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (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), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-01
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED 2/6/2021 with increasing SOB and found to have abnormal labs as an outpatient. Patient was found to be COVID positive on 2/6/2021 as well. Patient was discharged on 2/9/2021 for acute decompensations diastolic HF. At 2/19/2021 visit with Nephrology, patient found to have hypervolemic hyponatremia, not responding to oral diuretics and decision was made to manage as an inpatient. Patient found to have cardiomegaly, mild pulmonary vascular congestions with small bilateral pleural effusions, EF 59%, severely elevated pulmonary artery systolic pressure, and had a AKI. Patient did not improve with diuretic therapy. Hospice and comfort care measures were pursued and patient expired on 3/1/2021.


VAERS ID: 1145510 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Death, Dyspnoea, Hypersomnia, Musculoskeletal disorder, Respiration abnormal, Respiratory arrest, Respiratory rate decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Respiratory failure (narrow)

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

Write-up: Patient seen at my office 3/18/2021 (ambulatory). Had dose 2 on 3/19/21. The next morning around 5am (3/20), he had difficulty get to bathroom. Was holding onto the sink because his legs would not work. Family had to help him use bathroom and get him back into bed. Family got him bedside commode that day and even then had severe weakness like a "bowl of jelly". Had mild cough and neighbor listened to lungs and was clear. Cough cleared and had labored breathing intermittently. His breathing became more labored and he slept a lot and then breathing "kind of erratic" and then breathing slowed down and got slower and slower until he stopped breathing altogether. Passed on 3/21/2021.


VAERS ID: 1145526 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, Chest pain, Chills, Death, Dyspnoea, Headache, Heart rate increased, Pain in extremity, Pulmonary embolism, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-23
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3/13- First shot of Moderna vaccine received. 3/14- Sore arm, chills and a headache. 3/15- Shortness of breath and rapid heartbeat. 3/16- Went to ER because of more severe shortness of breath and rapid heartbeat. 3/17- COVID test with negative result. 3/19- Patient messaged her PCP explaining persisted symptoms. 3/23- Chest pain and shortness of breath developed and she died at ER in PEA. 3/25- Autopsy showed pulmonary embolism with no evidence of peripheral vascular disease. Double check COVID test with negative result.


VAERS ID: 1145531 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-02-12
Onset:2021-02-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Intensive care, Malaise, Myalgia, Respiratory failure, Respiratory symptom, SARS-CoV-2 antibody test negative, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-28
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: mycophenylate, tacrolimus, albuterol inhaler, diclofenac topical, mg oxide, pantoprazole
Current Illness: chronic illness as noted below
Preexisting Conditions: ESRD due to IgA nephropathy; s/p renal transplant 2014, diabetes type 2, HTN, hyperlipidemia, GERD
Allergies: cetirizine, HCTZ/lisinopril, metformin, morphine sulfate
Diagnostic Lab Data: NP swab PCR tests on 3/21/21 and 3/23/21 were both positive for SARS-CoV-2. Quantitaive SARS-CoV-2 spike protein Ab performed ~3/23 was negative.
CDC Split Type:

Write-up: Pt diagnosed with COVID-19 despite 2 COVID vaccines (first given 1/15/2021. Pt developed respiratory symptoms, including dyspnea, which progressed over 3.5 weeks and then systemic symptoms of myalgias, malaise. He was admitted 3/21/2021 and had positive NP swab for SARS-CoV-2 x 2. He required admission to ICU and died of respiratory failure on 3/28/2021.


VAERS ID: 1145552 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-23
Onset:2021-03-08
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient expired 3/8/2021 at home. Coroner pronounced time of death at 0415 and assumed cause of death was history of transplant and cardiac.


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