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From the 4/30/2021 release of VAERS data:

Found 3,837 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 38 out of 384

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VAERS ID: 976032 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-22
Onset:2021-01-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Constipation, Death, Decreased appetite, Dyspepsia, Hypoxia, Lethargy, Malaise, Multiple organ dysfunction syndrome
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-26
   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: Acetaminophen, Aspirin, Sinemet, Docusate, Eliquis, Finasteride, Fluticasone, Furosemide, Klor-con, Melatonin, Nortriptyline, Pantoprazole, Simvastatin, EMU muscle and joint relief cream, Synthroid, Tamsulosin, Vitamin B12, Vitamin D3, TUMS
Current Illness: CHF exacerbation in November 2020
Preexisting Conditions: CHF, CAD w/CABG, Pacemaker, CKD IV, HTN, Hyperlipidemia, Hypothyroidism, Osteoarthritis
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated he wasn''t feeling well on January 25, 2021, wasn''t eating and complained of abdominal pain. Patient noted to have indigestion and was constipated. Meds provided and labs ordered. On morning of January 26, 2021, patient became weak, lethargic and hypoxic and was sent to emergency department around 0700 hours on January 26, 2021. At approximately 1100 hours, emergency physician notified this writer that patient was not going to overcome his illness and would be placed on comfort care. At approximately 1130 hours, this writer was notified that patient had passed away from multi-organ failure.


VAERS ID: 976111 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-23
Onset:2021-01-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac arrest, Cardio-respiratory arrest, Cardioversion, Death, Dyspnoea, Pulseless electrical activity, Resuscitation, Somnolence, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-24
   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: warfarin (COUMADIN) 2.5 mg tablet zinc sulfate 220 (50) mg capsule nutritional supplements (NUTREN 1.5) 0.07 gram-1.5 kcal/mL liqd acetaminophen (TYLENOL) 325 mg tablet senna (SENOKOT) 8.6 mg tab furosemide (LASIX) 40 mg tablet spironolacto
Current Illness: Pt admitted with closed-loop bowel obstruction with subsequent surgery for ex-lap, SBR ~160cm jejunem and ileum, left with open abdomen with Abthera wound vac 12/22. Now s/p Exploratory laparotomy, primary stapled small bowel anastomosis, abdominal fascial and skin closure on 12/24.
Preexisting Conditions: Neurology Myalgia Secondary hypothyroidism ? Cardiovascular Coronary atherosclerosis of native coronary artery Postsurgical aortocoronary bypass status Chronic atrial fibrillation (HCC) Aortic insufficiency RBBB Essential hypertension, benign Pure hypercholesterolemia Bradycardia Typical atrial flutter (HCC) Severe aortic stenosis History of acute anterolateral myocardial infarction Thoracic aortic aneurysm without rupture (HCC) Ischemic cardiomyopathy Coronary artery disease involving autologous vein coronary bypass graft without angina pectoris Acute on chronic systolic heart failure (HCC) Acute on chronic systolic (congestive) heart failure (HCC) Chronic systolic congestive heart failure (HCC) ? Gastrointestinal Malnutrition of moderate degree (HCC) ? Nephrology BPH with obstruction/lower urinary tract symptoms Stage 3 chronic kidney disease (HCC) ? Endocrinology Acquired hypothyroidism ? Genetics/Metabolics Chronic gout of ankle ? Ophthalmology Nuclear sclerotic cataract of right eye Pseudophakia of left eye Exudative age-related macular degeneration of left eye with active choroidal neovascularization (HCC) Ocular trauma of right eye ? Rheumatology Primary localized osteoarthrosis, pelvic region and thigh ? Musculoskeletal Left leg swelling ? Psychiatry Delirium ? Other Statin intolerance Transient global amnesia CVA, ?Possible lacunar infarct right cerebellar Long term current use of anticoagulant therapy
Allergies: Statins (muscle weakness)
Diagnostic Lab Data:
CDC Split Type:

Write-up: CC:full arrest HPI:HPI and ROS limited due to patient''s condition. History is via EMS, medical record, and son. Per Son patient had Covid vaccine on Saturday morning. Slept all day Sunday. Woke up Sunday night a bit "like coming out of a deep sleep per son, around 10 pm. Shortly after that patient was having a hard time breathing. Emergency called. Arrested around the time EMS arrived. King airway, I/O and CPR initiated. Patient has been in v fib. Was shocked multiple times, given 4 rounds of epi, bicarb and amiodarone. ACLS continued on arrival. Multiple rounds of epi, and attempted defib. Patient given epi, bicarb. Rhythms included fine v fib, asystole, and PEA. Unrecoverable with no cardiac motion. Time of death 11:50 pm.


VAERS ID: 976112 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-07
Onset:2021-01-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Death, Decreased appetite
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Tartrate Tablet 25 MG BID Norvasc Tablet 10 MG (amLODIPine Besylate) QD Namenda Tablet 5 MG (Memantine HCl) BID Cozaar Tablet 100 MG (Losartan Potassium) QD hydrALAZINE HCl Tablet 25 MG TID Amiodarone HCl Tablet 200 MG QD CloNID
Current Illness: Resident started manifesting loss of appetite and body weakness on January 10,2021 a few days after vaccination. She expired in our facility 1/21/2021.
Preexisting Conditions: HEMIPLEGIA AND HEMIPARESIS FOLLOWING OTHER NONTRAUMATIC 10/28/2020 Principal Diagnosis INTRACRANIAL HEMORRHAGE AFFECTING LEFT DOMINANT SIDE TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE UNSPECIFIED ATRIAL FIBRILLATION ENTIAL (PRIMARY) HYPERTENSION 10/28/2020 Diagnosis 4 Admission HISTORY OF FALLING 10/28/2020 Diagnosis 5 Admission OTHER ABNORMALITIES OF GAIT AND MOBILITY 01/13/2021 Other Diagnosis During Stay COVID-19
Allergies: ASPIRIN PENICILLIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resident expired on january 21, 2021


VAERS ID: 976146 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-07
Onset:2021-01-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asymptomatic COVID-19
SMQs:, COVID-19 (narrow)

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: Multivitamin Liquid (Multiple Vitamins-Minerals) Give 5 ml via G-Tube one time a day for (SUPPLEMENT) Aspirin Tablet Chewable 81 MG Give 1 tablet via G-Tube one time a day for (CVA PROPHYLAXIS) Norvasc Tablet 5 MG (amLODIPine Besylate) G
Current Illness: No symptoms after COVID vaccinations
Preexisting Conditions: ENCOUNTER FOR SURGICAL AFTERCARE FOLLOWING SURGERY ON THE DIGESTIVE SYSTEM ENCOUNTER FOR ATTENTION TO GASTROSTOMY CONTACT WITH AND (SUSPECTED) EXPOSURE TO OTHER VIRAL COMMUNICABLE DISEASES UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE DEGENERATIVE DISEASE OF NERVOUS SYSTEM, UNSPECIFIED ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS UNSPECIFIED SEQUELAE OF UNSPECIFIED CEREBROVASCULAR DISEASE PAROXYSMAL ATRIAL FIBRILLATION UNSPECIFIED CIRRHOSIS OF LIVER ESSENTIAL (PRIMARY) HYPERTENSION UNSPECIFIED VIRAL HEPATITIS B WITHOUT HEPATIC COMA HYPERLIPIDEMIA, UNSPECIFIED GASTRITIS, UNSPECIFIED, WITHOUT BLEEDING UNSPECIFIED PROTEIN-CALORIE MALNUTRITION
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Resident is asymptomatic


VAERS ID: 976166 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-07
Onset:2021-01-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-18
   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: Gabapentin Capsule 100 MG, Give 1 capsule orally one time a day for (NEURALGIA) Losartan Potassium Tablet 50 MG, Give 1 tablet orally one time a day for (HYPERTENSION) HOLD IF SBR<110 OR HR<60 Norvasc Tablet 5 MG (amLODIPine Besylate), Give
Current Illness: NONE
Preexisting Conditions: HEMIPLEGIA AND HEMIPARESIS FOLLOWING NONTRAUMATIC INTRACEREBRAL HEMORRHAGE AFFECTING RIGHT DOMINANT SIDE CONTACT WITH AND (SUSPECTED) EXPOSURE TO OTHER VIRAL COMMUNICABLE DISEASES ACIDOSIS ANEMIA UNSPECIFIED SEVERE PROTEIN-CALORIE MALNUTRITION PERSONAL HISTORY OF OTHER MALIGNANT NEOPLASM OF LARGE INTESTINE ACUTE KIDNEY FAILURE, UNSPECIFIED UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE NEURALGIA AND NEURITIS, UNSPECIFIED ESSENTIAL (PRIMARY) HYPERTENSION
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: ASYMPTOMATIC


VAERS ID: 976280 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-01-21
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 - / IM

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

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: GABAPENTIN; PREGABALIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death on 21 Jan 2021 - coroner called provider office


VAERS ID: 977319 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Michigan  
Vaccinated:2020-12-29
Onset:2021-01-25
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Notified by patient''s sister on 1/26/2021 that patient died in his sleep on 1/25/2021. She did not know cause of death.


VAERS ID: 977320 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-25
Onset:2021-01-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Death, Dyspnoea, Intensive care, Life support, Resuscitation
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: 2021-01-26
   Days after onset: 0
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: unknown
Current Illness: acute pancreatitis, gerd, ibs, OA, rheumatoid arthritis, HTN, H/o falls, osteoporosis, pre-diabetes, hyperlipidemia, diverticulosis, interstitial lung disease, permatomyoitis
Preexisting Conditions: acute pancreatitis, gerd, ibs, OA, rheumatoid arthritis, HTN, H/o falls, osteoporosis, pre-diabetes, hyperlipidemia, diverticulosis, interstitial lung disease, permatomyoitis
Allergies: azathioprine (Imuran)
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 20+ hours after vaccination resident was having hard time breathing, 911 was called. Resident coded multiple times at the facility after CPR she was taken to ICU. She coded again and was placed on life support. Due to her choice to not be on life support she passed on 11/26/2021.


VAERS ID: 977358 (history)  
Form: Version 2.0  
Age: 99.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-08
Onset:2021-01-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiac failure congestive, Chest X-ray, Cough, Death, Full blood count, Laboratory test, SARS-CoV-2 test, Ultrasound chest
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 9
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: Lisinopril, ASA, Paxil, Amlodipine
Current Illness:
Preexisting Conditions: anemia, mild renal insufficiency, hypertension
Allergies: none
Diagnostic Lab Data: CBC, SMA6 Jan 18, Jan20 Covid 19 test Jan 20 Chest X Ray Jan 20 Chest ultrasound Jan 20
CDC Split Type:

Write-up: cough congestive heart failure death


VAERS ID: 977426 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-20
Onset:2021-01-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Death, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol, Dexamethasone, Pantoprazole, Dilatin, Plaxis, Aspirin, VImpat, Keppra, Clopidogrel
Current Illness: 1. Melanoma with brain metastasis 2. Seizure disorder
Preexisting Conditions: 1. Melanoma with brain metastasis 2. Seizure disorder
Allergies: None
Diagnostic Lab Data: None. He was under hospice care.
CDC Split Type:

Write-up: Patient has a history of advanced melanoma with brain metastasis. He developed seizure disorder as well and had some mild seizures at home over the prior month. He received the vaccine at 4pm and was monitored in the office for 15 minutes. He then went home with his daughter whom he lives with. He ate dinner with her and read until 8pm when he went to his room. She found him in his room at 9pm unresponsive with seizures. Hospice was alerted and recommend oral valium. He continued to be unresponsive and expired the following day at 7:30 pm.


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