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

Found 16,766 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 30 out of 1,677

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VAERS ID: 965565 (history)  
Form: Version 1.0  
Age: 84.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2020-12-26
Onset:2021-01-05
   Days after vaccination:10
Submitted: 2021-01-19
   Days after onset:14
Entered: 2021-01-22
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-05
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Narrative: Please note that patient is a hospice patient. Death occurred 10 days post vaccination. Providers do not believe that there was a correlation. Facility requires that we reports all death even if we suspect no correlation between death and vaccine. Symptoms: & death


VAERS ID: 965571 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-13
Onset:2021-01-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Dysarthria, Fatigue, Malaise, Memory impairment
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1/13/21 pt came into clinic for vaccine. Had difficulty remembering age. Called me Mon. 1/18/21 stating she was sick. When asked what her sx were, she stated fatigue. She was well the night of the shot, Thur. and Fri. but became tired on Sat. and Sun. I went through other sx with her such as h/a, fever, n/v, muscle aches, weakness and she said she experienced none of those. I questioned her about eating and drinking and she said she ate and drank water. She seemed fine so I told her to call her doctor if she was worse or the fatigue persisted or call 911. She agreed. Two staff from clinic called her Mon. and Tues, (1/18 and 1/19). On Tues. she may have had sl slurred speech. She was found deceased on


VAERS ID: 965807 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-08
Onset:2021-01-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Immobile, Pruritus, Respiratory disorder, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-16
   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: metoprolol, methotrexate, calcitrol, digoxin, calcium prednisone, clopidogrel, levothyroxine, folic acid, pantoprazole, eliquis, atorvastatin, latanoprost, melatonin
Current Illness: nose bleeds
Preexisting Conditions: rheumatoid arthritis, atrial fibrillation
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: began itching within 24 hours, within 5 days couldn''t move on her own, by 6th day was having respiratory issues, by day 7 unresponsive, by day 8 dead


VAERS ID: 965831 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-18
Onset:2021-01-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   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: Albuterol Sulfate HFA 108 MCG/ACT AERS Allopurinol 300 MG Oral Tablet Aspirin Low Dose 81 MG TABS Baclofen 10 MG Oral Tablet Bystolic 10 MG Oral Tablet Clobetasol Propionate 0.05 % External Cream Cyanocobalamin 1000 MCG TABS Fish Oil
Current Illness: Emergency Room Visit 1/7/2021 complaining of shortness of breath and swelling. She and elevated D-dimer with no evidence of a Pulmonary Embolus. Persantine Myoview showed small mild area of reversible ischemia to the inferolateral apical wall. Mild symptoms of vague discomfort in her chest, but nothing that has been reproducible with activity. She is chronically short of breath with limited activities because of problems with her hip
Preexisting Conditions: Active Problems Abdominal distention (R14.0) Cellulitis (L03.90) Chronic hip pain (M25.559,G89.29) Chronic UTI (N39.0) Colon polyps (K63.5) Coronary artery disease involving native coronary artery of native heart with angina pectoris (I25.119) Edema, leg (R60.0) GERD (gastroesophageal reflux disease) (K21.9) Gout (M10.9) Left kidney mass (N28.89) Lump of right breast (N63.10) Morbid obesity (E66.01) Neuropathy, diabetic (E11.40) Pain with urination (R30.9) Protein in urine (R80.9) Respiratory crackles at right lung base (R09.89) Type 2 diabetes mellitus (E11.9) Venous (peripheral) insufficiency (I87.2)
Allergies: Allergies: Brilinta, ACE Inhibitors, Bactrim, Cipro, Codeine Derivatives, Penicillins, Statins, sulfa
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received her first dose of vaccine on Monday, January 18th. Two days later on Wednesday, January 18th, she retired to bed early. Later that night when her husband went to bed, he found her in the bed deceased. No other details of the event are know.


VAERS ID: 965860 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-21
Onset:2021-01-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Dyspnoea
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had increased SOB while at home. EMS was called. Patient coded in the squad


VAERS ID: 965910 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-01-11
Onset:2021-01-22
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ELI284 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   Days after onset: 21
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: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: Not known at this time.
CDC Split Type:

Write-up: The employee found dead at her home on 1/21/2021.


VAERS ID: 965922 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-19
Onset:2021-01-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-22
   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: unknown
Current Illness: pt denied
Preexisting Conditions: pt denied
Allergies: pt answered no
Diagnostic Lab Data:
CDC Split Type:

Write-up: We were alerted that the patient died at home.


VAERS ID: 966178 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-01-19
Onset:2021-01-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-22
   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: acetaminophen 600 mg every 4 hrs, albuterol 2 puffs every 6 hrs, Symbicort 2puffs 2 x days, vitamin D, B12, Prozac 20 mg once per day, Veramyst 1 spray once per day, Lisinopril 5 mg once per day, Prilosec 40 mg once per day, Probiotic daily
Current Illness: skin ulcer of lower right leg due to old gun shot wound
Preexisting Conditions: alcoholism in remission, aortic stenosis-mild, arthritis, blood loss anemia, carpel tunnel syndrome bilateral, cellulitis of right leg, chronic insomnia, COPD, diverticulosis of sigmoid and descending colon, eczema, gun shot wound of leg, heart murmur-right upper external border, hemorrhoids, history of blood transfusion, history of falling, lyme disease, osteoarthritis of left knee, pneumonia, polyp of colon flat, peripyloric ulcer, peptic ulcer disease, sleep apnea, unspecified essential hypertension, viral meningitis
Allergies: aminoglycosides and sulfa meds
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt called son to let him know he couldn''t breath around 2 AM. Pts son showed up at his house 10 minutes later and ambulance arrived with in 20 minutes at 2:15


VAERS ID: 966359 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-01-19
Onset:2021-01-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029K20A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Death, Headache, Injection site pain, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-20
   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: Levothyroxine, Gabapentina, furosemide, Losartan, pravastatin
Current Illness: Diabetes, hyper tension
Preexisting Conditions: Diabetes
Allergies: Aleve
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, pain in the injection site, threw up. A few hours later she died.


VAERS ID: 966844 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-13
Onset:2021-01-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Feeling abnormal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: DM II
Preexisting Conditions: DM II
Allergies: KNA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is reported to have died at home, the day after his COVID test. Family member states that he did good the afternoon and evening after his COVID-19 injection, but that he started not feeling good the next day. The patient "was having palpitations". The family tried to convince him to go to the Emergency Room, but he refused. Patient died at home.


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