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From the 7/23/2021 release of VAERS data:

Found 11,940 cases where Vaccine targets COVID-19 (COVID19) and Patient Died



Case Details

This is page 57 out of 1,194

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VAERS ID: 998422 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-30
Onset:2021-01-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood albumin, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium, Blood chloride normal, Blood creatine phosphokinase MB decreased, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase normal, Blood creatinine increased, Blood glucose increased, Blood lactic acid, Blood lactic acid normal, Blood potassium normal, Blood sodium decreased, Blood urea increased, Blood urine absent, Brain natriuretic peptide normal, Carbon dioxide decreased, Cerebral atrophy, Chest X-ray normal, Computerised tomogram head normal, Dehydration, Full blood count normal, Haematocrit normal, Haemoglobin decreased, Hypophagia, Hyporesponsive to stimuli, Immunology test, Mental status changes, Metabolic function test, Muscular weakness, Platelet count normal, Procalcitonin normal, Protein urine, Pyrexia, SARS-CoV-2 test negative, Somnolence, Specific gravity urine normal, Troponin I normal, White blood cell count normal, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-21
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg daily; cimetidine 300 mg 4 times a day; donepezil 10 mg daily; fluticasone nasal spray daily; gabapentin 600 mg 3 times a day; glipizide 2.5 mg daily; losartan 100 mg daily; memantine10 mg twice a day; metformin 500 mg twice
Current Illness: None
Preexisting Conditions: Type II diabetes, hypertension, hypothyroidism, GERD, hyperlipidemia, early dementia.
Allergies: None
Diagnostic Lab Data: 2/2: WBC 8.7, H/H 13.6/40.5; Plt 185,000; Glucose 173, BUN 23, creatinine 1.5, Na 135, K 4.7, Cl 102, CO2 22, Ca 8.3, Tot protein 6.1, albumin 3.5, ALP 71, AST, 20, ALT 12, Tot bili 0.30, BNP 24, CPK 131, CKMB 1.8, troponin i <0.06. SARS FIA negative. UA: sp gr 1.025, pH 7.0 1+ protein, neg blood o/w normal. 2/3: WBC 8.4, H/H 12.4/36; BUN 18, creat1.1 CT head normal for age; CXR no evidence of infection.
CDC Split Type:

Write-up: patient developed progressive diffuse muscle weakness, altered mental status including excessive drowsiness, decreased oral intake starting on 1/31/2021. Symptoms continued to worsen overnight and he was evaluated in the emergency room on 2/2/2021 and admitted with dehydration and altered mental status. He was aggressively hydrated overnight, but showed persistent diffuse muscle weakness, altered mental status with decreased responsiveness progressing, but no focal neurological findings noted. CT scan of the head on 3/3/2021 showed no findings other than age-related diffuse cerebral atrophy. The patient did spike a fever to 103 on the morning of 2/3/2021. CBC, CMP, procalcitonin and lactic acid levels remained normal. He remains hospitalized in stable condition as of 2/3/2021 @1300.


VAERS ID: 998463 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-06
Onset:2021-01-19
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Acute coronary syndrome, Death, Endotracheal intubation, Laboratory test, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Myocardial infarction (narrow), 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), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-19
   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 amlodipine calcium carbonate + vitamin D3 Celebrex (PRN) Irbesartan lidocaine patch loratadine polyethylene glycol pravastatin
Current Illness: pneumonia, acute hypoxic respiratory failure
Preexisting Conditions: HTN HLD Osteoarthritis osteoporosis impaired mobility secondary to avascular necrosis or right humeral head, and s/p ankle fusions, bilateral knee replacements Sciatica open angle glaucoma
Allergies: horse chesnut seed extract
Diagnostic Lab Data: Tests/ results were performed in hospital, outside of our setting (nursing home).
CDC Split Type:

Write-up: Resident passed away unexpectedly on 01/19/21 after developing acute hypoxic respiratory failure on morning of 01/19/21. She was transferred to hospital via EMS where she was intubated, coded, and ultimately expired with uncertain underlying cause, potentially ACS.


VAERS ID: 998544 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-13
Onset:2021-01-25
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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: Multiple medication
Current Illness: diabetes, heart trouble, dementia
Preexisting Conditions: as above
Allergies: Morphine and iodine
Diagnostic Lab Data: Stents placed.
CDC Split Type:

Write-up: Patient had heart attack. Spoke with spouse on 2/3/2021 stated had multiple health issues including heart and lung issues.


VAERS ID: 998576 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-27
Onset:2021-01-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Atelectasis, Blood creatinine increased, Blood culture negative, Blood potassium increased, Blood urine present, Brain natriuretic peptide increased, Cardiac telemetry, Chest X-ray abnormal, Electrocardiogram abnormal, Full blood count normal, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Metabolic function test, Pleural effusion, Protein urine present, Pulmonary oedema, Pyrexia, Respiratory distress, SARS-CoV-2 test negative, Sinus tachycardia, Troponin increased, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-31
   Days after onset: 4
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: Med List @ time vaccine # 2: PRN acetaminophen Bisacodyl PRN TUMS Clotrimazole Flonase Loratadine Lorazepam Melatonin Bengay Nitrostat Zofran oxycodone Miralax Scheduled: acetaminophen 500 md QID amlodipine 5mg BID Metoprolol 50 mg BID Pra
Current Illness: NSTEMI after COVID vaccine #1
Preexisting Conditions: CAD, CKD4, Hypertension, Anemia, dementia
Allergies: DIPYRIDAMOLE, ERYTHROMYCIN, TERAZOSIN
Diagnostic Lab Data: 1/1/2021 CMP remarkable for Potassium 5.8, creatinine 3.20, HS troponin 2.2, 310 BNP 12.7, CBC unremarkable, UA++ protein 1+ blood, Blood Cx No growth x5 days, COVID RNA rapid (-), 1/2/21 COVID PCR (-), Influenza A+B (-), No EKG, Partial CXR no acute cardio pulmonary process, no pneumonia, Telemetry Strip (12/31 22:00 atrial fib normal rate. 1/27/21 CMP remarkable for potassium 6.1, Serum Creatinine 4.46, BNP 1080, HS troponin 13.2, CBC with diff unremarkable, COVID PCR (-), EKG sinus tachycardia, QRS algorithm, left axis deviation rate 107 borderline criteria arterial infarct, CXR Bilateral + alveolar opacities compatible with pulmonary edema, small (L) pleural effusion, (L) basilar air space likely atelectasis
CDC Split Type:

Write-up: Had acute respiratory failure, dysuria NSTEMI after Dose #1 Lot # 025L20A (Moderna) hospitalized same day 12/31/20 administered @ 1040 back to baseline. 2nd Dose on 1/27/21 0950 Lot as above. Unknown exact onset same day, ED by EMS @ 1745, respiratory distress, febrile 39.4 degrees C BP 150/105 RR 29


VAERS ID: 998579 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-25
Onset:2021-02-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Senior Living       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: Patient is a nursing home resident please notify facility.
Current Illness: Patient is a nursing home resident please notify facility.
Preexisting Conditions: Patient is a nursing home resident please notify facility.
Allergies: Iodine, ACE Inhibitors
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resident passed away 2/2/2021.


VAERS ID: 998637 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-13
Onset:2021-01-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Arrhythmia, Cardiac arrest, Irregular breathing, Resuscitation, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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: 2021-01-15
   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:
Current Illness: No known acute illness
Preexisting Conditions: Macular degeneration Dislipidemia
Allergies: None noted
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient noted to have irregular breathing in bed and unable to arouse. Provided life saving measures in the field x 30 minutes and transferred to hospital. Noted to have heart arrhythmia which suspected to cause cardiac arrest.


VAERS ID: 998770 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-01-28
Onset:2021-01-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Dyspnoea, Hypopnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow)

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: OTC APAP prn Tradjenta 5mg daily amlodipine 10mg daily naproxen 500mg BID trazodone 100mg HS atorvastatin 20mg daily gabapentin 100mg TID timolol 0.5% eye drops 1 drop each eye BID metformin ER 500mg daily glipizide 10mg BID lisinopril 20m
Current Illness:
Preexisting Conditions: High blood pressure High Cholesterol Diabetes Restless Legs syndrome depression/anxiety
Allergies: NKA
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient had no symptoms or adverse events until the next evening after shot (1/29/21) where daughter reported her having heart palpitations. Family told her to rest and did not seek medical attention. Saturday afternoon (1/30/2021), patient started experiencing labored breathing. Daughter called 911 and before the ambulance arrived, the patient''s breathing became more and more shallow. Patient was taken to the local hospital and passed away Saturday evening around 5:30 pm.


VAERS ID: 1002931 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-21
Onset:2021-01-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Absence of immediate treatment response, Cardiac arrest, Cardio-respiratory arrest, Death, Electrocardiogram ST segment elevation, Endotracheal intubation, Pulseless electrical activity, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Lack of efficacy/effect (narrow), Myocardial infarction (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), Cardiac arrhythmia terms, nonspecific (narrow), Respiratory failure (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? Yes
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:

Write-up: CARDIAC ARREST, DEATH Narrative: The patient presents to the emergency department in cardiopulmonary arrest. CPR was continued upon arrival. The Combi tube was removed and an endotracheal tube was placed without complications. ROSC was obtained multiple times but the patient continued to go into PEA. The patient was seen in the emergency department by both critical care and Cardiology. EKG shows ST elevations, but the patient was unstable to go to catheterization. The patient had 1 episode of asystole. Despite best efforts and multiple attempts we were unable to resuscitate the patient. Time of death 1253 on 1/24/21.


VAERS ID: 1002937 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-02-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, Cardio-respiratory 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), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
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:

Write-up: death Narrative: Pt attended arthritis clinic appt 0900; labs shortly after; rec''d vaccine in clinic ~ 1113; seen on surveillance camera walking to parking garage ~ 1145; medical center rec''d call from wife ~ 1900 that pt never returned home; police found vehicle running in parking garage, code called, pt obviously deceased by that time 1930, body sent to medical examiner for autopsy.


VAERS ID: 1000226 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-19
Onset:2021-01-27
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Ischaemia, Surgery, Volvulus
SMQs:, Gastrointestinal obstruction (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021085163

Write-up: volvulus; volvulus and needed surgery followed by further ischemia; This is a spontaneous report from a contactable physician. An 86-year-old female patient received her first single dose of BNT162B2 (Pfizer-BioNTech Covid-19 vaccine) intramuscularly on 19Jan2021 for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient had no known allergies. The patient developed volvulus and needed surgery followed by further ischemia and at end of life. The events onset date reported as 27Jan2021. Patient had 3days hospitalization and died eventually. It was unknown if an autopsy was performed. Information about lot/batch number has been requested.; Sender''s Comments: Very limited information was provided in this report. No relevant information regarding the clinical course of the events, the patient''s underlying medical conditions were mentioned. Based on the information currently available, lacking any other alternative explanations as so far, the reported volvulus and Intestinal ischaemia are managed as related to COVID-19 vaccine, BNT162B2, for reporting purpose, only. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RA, IEC, as appropriate.; Reported Cause(s) of Death: volvulus; ischemia


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