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From the 4/23/2021 release of VAERS data:

Found 3,544 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 54 out of 355

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VAERS ID: 995649 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-25
Onset:2021-01-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cardiac arrest, Death
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-30
   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:
Current Illness: none
Preexisting Conditions: Thyroid disorder, HTN, Peripheral neuropathy, anxiety
Allergies: Augmentin, sulfa
Diagnostic Lab Data: Hospitalization, EMS reports
CDC Split Type:

Write-up: Cardiac arrest; Patient transported by EMS to hospital 11:00pm on 01/29/2021. Patient received vaccine on 01/25/2021. Patient expired 01/30/2021 within the hour into the new day after midnight on 01/30/2021. Patient was feeling well prior to and any chronic health conditions were well controlled. Sudden cardiac arrest 4 days after receiving the vaccine. Details given by patients husband/POA.


VAERS ID: 995789 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-28
Onset:2021-01-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 1 LA / IM

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

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes Heart Condition
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient received the vaccine on the afternoon of Thursday, 1/28/21. He was observed for at least 30 minutes following administration of the vaccine with no reactions noted. He was found dead in his car on Sunday, 1/31/21. It is unknown if the vaccine contributed to his death.


VAERS ID: 995825 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-06
Onset:2021-01-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Delirium, Gastrointestinal haemorrhage, Sudden cardiac death, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-13
   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: Calcium carbonate Cholecalciferol Ezetimibe Insulin (Lantus) Levothyroxine Olanzapine melatonin pantoprazole Senokot-S Sitagliptin Preservision AREDS
Current Illness: Acute lower GI bleed (diverticular bleed) occurred in 12/21/2020 and hospitalization from 12/21-12/31/20 complicated by delirium
Preexisting Conditions: Type 2 DM HLD Macular degeneration Hearing loss HTN Hypothyroidism Osteopenia
Allergies: Statins, ace inhibitors, hydrocodone, metformin, codeine, metoprolol XL
Diagnostic Lab Data: N/A. Client had a DNR order and therefore resuscitation was not attempted.
CDC Split Type:

Write-up: Client unexpectedly collapsed and passed away on 1/13/21 from suspected sudden cardiac death. Prior to her death, she was in skilled care for rehabilitation following hospitalization from 12/21-12/31/20 for an acute lower GI bleed. Her hospitalization and skilled care stay were complicated by delirium and she was being treated for delirium with olanzapine (Zyprexa) at time of death.


VAERS ID: 995977 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-01-19
Onset:2021-01-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Altered state of consciousness, Hypercapnia, Imaging procedure, Laboratory test, Lethargy, SARS-CoV-2 test negative, Sinusitis
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant 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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-27
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Latest medication list available to us 12/18/19, due to record being deleted after death: CORN STARCH POWDER RED AREA BETWEEN 3RD AND 4TH FINGER RIGHT HAND - APPLY CORN STARCH FOUR TIMES DAILY - FACILITY TO SUPPLY ACYCLOVIR 200MG CAPSULE 1
Current Illness: N/A
Preexisting Conditions: 0 Profound intellectual disability (F73) secondary to Angelman''s Syndrome with microcephaly (Q38.2); Macroglossia (750.15), rumination (307.53) and aerophagia, S|P aspiration pneumonia 9/98(507.0), history of coagulopathy (286.9); finger clubbing probably secondary to chronic pulmonary disorder; surgery 12/70 for undescended testes; Nissen fundoplication w/pyloroplasty 5/2/88; H/o Acne Vulgaris (L70.0) 31 Inability to monitor own health care needs. Frequent urinary tract infections. 39 Gastroesophageal reflux (K21.9) 56 Megacolon and tendency to fecal impaction (K59.3, K56.4) 57 Hand mouthing secondary to Angelman''s syndrome 59 Chronic recurrent herpes simplex (B00.9) 60 Recurrent cyanosis (R23.0), secondary to mucus plugging 61 Maintain optimal nutritional status altered by severe dysphagia (R13.10) 62 Osteoporosis probably secondary to immobility (M81.0) 63 Needs to maintain optimal musculoskeletal status 64 Optic atrophy(H47.20)secondary to Angelman?s syndrome, myopia(H52.10) 77 Prone to dehydration 83 Hiatal hernia (K44.9) 84 Peripheral vascular disease, poor circulation of bilateral ankles and feet. ?? Frequent UTIs. Small bilateral renal stones.
Allergies: Aspirin, NSAIDs.
Diagnostic Lab Data: Multiple imaging studies and lab tests while hospitalized. Covid negative 1/25/21.
CDC Split Type:

Write-up: Lethargy/altered level of consciousness lead to hospital admission. Multiple interventions during hospitalization. Final hospital diagnoses: Acute respiratory failure with hypercapnia, acute pansinusitis.


VAERS ID: 996086 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-07
Onset:2021-01-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Acute kidney injury, Acute myocardial infarction, Acute respiratory distress syndrome, COVID-19 pneumonia, Cardiac failure acute, Cough, Death, Intensive care, Myalgia, Oropharyngeal pain, Pyrexia, Renal replacement therapy, Rhabdomyolysis, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), 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 (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-31
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: h.o HTN, elevated BMI
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt received vaccine on 7 jan. 2021 Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19. Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on multiple pressor, rhabdomyolysis with acute kidney injury, requiring CRRT. Pt was in hospital for 10 days; he passed away on 31 Jan 2021.


VAERS ID: 996105 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-23
Onset:2021-01-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / IM

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

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: Levothyroxine, senna, multivitamins, aspirin and possible hospice medications
Current Illness: Dementia, hypothyroidism, coronary artery disease, patient was already on hospice, so unclear if vaccine related . Pt was at her baseline until she passed away
Preexisting Conditions: Dementia, hypothyroidism, coronary artery disease, HTN, multiple other medical issues
Allergies: Egg, co-trimoxazole, Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: patient received vaccine on Jan 23, 2021 passed away on Jan 24, she was already on hospice, so unclear if due to vaccine or other issues. Was at her baseline before and after vaccine per facility, had b''fast and passed away at noon on Jan 24


VAERS ID: 996156 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-01
Onset:2021-02-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Arthralgia, Death, Impaired work ability, Injection site pain, Malaise, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-02
   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: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client came to nursing station about 2pm to report she "was not feeling well". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was "off the charts" and that she had pain covering her whole left side of her body. She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home. 911 was immediately called and authorities took over the scene.


VAERS ID: 996259 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-19
Onset:2021-01-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, SARS-CoV-2 test negative
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-29
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine HCL, 20 mg, Magnesium Oxide, 400 mg, Atrovastatin/Calcium, 10 mg, Omprazole, 20 mg, Lisinoprilm 2.5.mg, Lyrica, 200mg, Metoprolol Tartrate, 25 mg , Potassium Chloride 20 meq,
Current Illness: COPD, Chronic Hypoxemic respiratory failure, Chronic bronchitis, Atrial Fibrillation, OSA on CPAP
Preexisting Conditions: COPD, Chronic Hypoxemic respiratory failure, Chronic bronchitis, Atrial Fibrillation,
Allergies: Wellbutrin, Niaspan
Diagnostic Lab Data: Reported by hospital patient was COVID negative. Dr. office did not receive any additional lab information or treatment to her office.
CDC Split Type:

Write-up: Unknown. Was informed that the patient went to E/R on 1/25/21 (6 days after receiving vaccine. Died 1/29/21 ( 10 days after receiving vaccine).


VAERS ID: 996291 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-01-07
Onset:2021-01-29
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-29
   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: Haloperidol, Morphine, Lorazepam
Current Illness: HTN, Cerebral Infarction, Anxiety, Hx breast neoplasm
Preexisting Conditions: HTN, Cerebral Infarction, Anxiety, Hx breast neoplasm
Allergies: Codeine, Tramadol, Valsartan, Keflex, Penicillins
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Death


VAERS ID: 996423 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-01-04
Onset:2021-01-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-10
   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: Wife reported patient had diabetes and high blood pressure.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had a CVA and passed away suddenly 1/10/21


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