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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 66 out of 384

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VAERS ID: 1011492 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-01-07
Onset:2021-01-27
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood calcium normal, Blood chloride increased, Blood creatinine normal, Blood potassium normal, Blood sodium normal, Blood urea increased, COVID-19, Death, Dysphagia, Full blood count, Haematocrit normal, Haemoglobin decreased, Lethargy, Metabolic function test, Oxygen saturation decreased, Platelet count normal, Polymerase chain reaction positive, Red blood cell count decreased, SARS-CoV-2 test positive, White blood cell count normal
SMQs:, Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-27
   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: Escitalopram Miralax Isosorbide Mononitrate Lactulose Melatonin Milk of Magnesium, Protnix, Acetaminophen, Senna-S, Zyprexa, Aspercreme lot
Current Illness: NONE
Preexisting Conditions: CAD, Bradycardia, HTN, Hyperlipidemia, Protein Calorie Malnutrition, GERD, STEMI, Vitamin D deficiency
Allergies: Macrobid
Diagnostic Lab Data: CBC and BMP 12/2/2021-not Covid-19 related: WBC 6.17 RBC 3.80 HGB 11.2 HCT 36.6 Platelet Count 234 BUN/CREA 22/0.64 Creatinine 0.64 Calcium 9.0 Sodium 144 Potassium 3.9 Chloride 111 1/18/2021- PCR positive.
CDC Split Type:

Write-up: 1/18/2021- Tested positive for Covid-19. 1/20 Patient lethargic, unable to swallow. 1/24 Although 90% O2 sat on RA, it has decreased from her baseline ranging at high 90''s. 1/27/2021 Patient passed.


VAERS ID: 1011577 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-04
Onset:2021-02-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cough, Death, Increased bronchial secretion, Productive cough, Rhinorrhoea, Secretion discharge, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-05
   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: albuterol sulfate nebulization hyoscyamine sulfate atropine sulfate lorazepam concentrate morhpine sulfate metolazone lasix benadryl robitussin levothyroxine fluocinonide cream nystatin cream remeron spironolactone tylenol extra strength tr
Current Illness: Was started on hospice between first dose of vaccine (1/7/21) and second dose (2/4/21), primarily for inability to control fluid balance due to heart failure and kidney failure. Started to have increased edema and respiratory symptoms (nasal drainage, raspy voice but denied sore throat) and tested negative for COVID twice starting 1/5/21 and 1/7/21 (day of first vaccine), and once again after the vaccine, increased confusion at that time and continued between vaccination. Later the nasal drainage was attributed to fluid overload. UTI on 1/11/21. Hospice referral by MD on 1/15/21.
Preexisting Conditions: History of type 2 diabetes, benign prostatic hyperplasia, heart failure, hypertension, constipation, vitamin D deficiency, hypothyroidism, chronic kidney disease stage 3, insomnia, tinea corporis, macular degeneration, polyosteoarthritis, UTIs. Short term memory difficulties. Resided in LTCF for 3 years prior to death.
Allergies: no known allergies
Diagnostic Lab Data: None performed due to hospice status.
CDC Split Type:

Write-up: Resident expired on 2/5/21 at 03:35pm, about 25 hours after second dose of vaccine. At breakfast, resident was spitting a lot of secretions, coughing up liquids from nose and phlegm, facial swelling, which were all symptoms that he was struggling with prior to both doses of COVID vaccine, but had increased more than prior incidences on 2/5/21. Gurgling noted in upper airways, hyscolamine given, bath given to loosen secretions, morphine given. Family notified and came into facility for compassionate care visit around 1300. 1400 HR was 3 and RR was 2, but increased back to 60 and 12 within 20 minutes. Then resident expired at 1535.


VAERS ID: 1011595 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-28
Onset:2021-02-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Azotaemia, Blood creatinine increased, Blood urea increased, Brain natriuretic peptide, Cardiac arrest, Death, Full blood count, Metabolic function test, Renal failure, Ventricular fibrillation, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (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), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-07
   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: Glimepiride Tablet 1 MG,hydrALAZINE HCl Tablet 10 MG,Pantoprazole Sodium Tablet Delayed Release 40 MG,Meclizine HCl Tablet,Isosorbide Mononitrate ER Tablet Extended Release 24 Hour 30 MG,Senna Tablet 8.6 MG (Sennosides),Furosemide Tablet 20
Current Illness: ACUTE RESPIRATORY FAILURE WITH HYPOXIA, COPD, CHF, HTN, ANEMIA IN CHRONIC KIDNEY DISEASE, TYPE 2 DIABETES MELLITUS WITH DIABETIC NEPHROPATHY, GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS, HYPERLIPIDEMIA, UNSPECIFIED, DEMENTIA, AFIB, CKD STAGE 4, BENIGN PROSTATIC HYPERPLASIA WITHOUT LOWER URINARY TRACT SYMPTOMS, UNSPECIFIED ASTHMA, UNCOMPLICATED, HYPERPARATHYROIDISM, UNSPECIFIED
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: BNP, CBC, CMP
CDC Split Type:

Write-up: On 2/5/2021 resident noted to be azotemic. Creatinine up to 3.8 and BUN in 80''s. He was started on NS hydration. On 2/7/2021 he was noted without VS, per MD notes, possible VF arrest, renal failure; death unclear exact cause.


VAERS ID: 1011677 (history)  
Form: Version 2.0  
Age: 101.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-01-07
Onset:2021-01-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood albumin decreased, Blood creatinine increased, Blood thyroid stimulating hormone normal, Blood urea increased, COVID-19, Decreased appetite, Food refusal, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin increased, Lethargy, Platelet count normal, Red blood cell count decreased, Refusal of treatment by patient, SARS-CoV-2 test positive, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-26
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen Tablet Exelon Patch Lisinopril Tablet Metoprolol Tartrate Tablet Protonix
Current Illness: 01/16/2021 Pt had bried unresponsive episode
Preexisting Conditions: Alzheimer''s disease, Hx of TIA, Vitamin D deficiency, HTN, Syncope and collapse, Hyperlipidemia.
Allergies: NKA
Diagnostic Lab Data: 1/07/2021 CBC/BMP: WBC-10.86 RBC- 3.76 HGB-106 HCT- 34.6 Platelet count-282 BUN/CREA-33/1.49 ALBUMIN-2.5 GFR-32 12/29- TSH -1.930
CDC Split Type:

Write-up: Lethargic, refusing medications and meals. 1/11/2021- Covid+, poor appetite.


VAERS ID: 1011732 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-30
Onset:2021-02-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-03
   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 passed away with in 60 days of receiving COVID vaccine series


VAERS ID: 1011774 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-03
Onset:2021-02-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 RA / SC

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Death, Resuscitation, Syncope
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), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-06
   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: ASPRIN CLOPIDOGREL LISINOPRIL NITROQUICK FINASTERIDE AMLODPINIE PRAVASTATIN TAMSULOSIN
Current Illness: CAROTID ARTERY STENOSIS CORONARY ARTERY DISEASE PACEMAKER CABG, 4-VESSEL BPH
Preexisting Conditions: SAME AS ABOVE
Allergies: NONE KNOWN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Cardiac arrest resulting in death on the third day post vaccine administration, 0224. Reported syncopal event post toileting. Rescue measures attempted but not successful. Time of death 0358, 02/06/2021.


VAERS ID: 1011834 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-02-06
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-06
   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 passed away within 60 days of receiving COVID vaccine series


VAERS ID: 1011894 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-02-04
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   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 passed away within 60 days of receiving COVID vaccine


VAERS ID: 1011905 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-01-08
Onset:2021-01-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, General physical health deterioration, Lethargy, SARS-CoV-2 test positive
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-02
   Days after onset: 13
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Refused medications on day of vaccine. Aspirin Tablet 81 MG(Last dose 1/6 8am), Docusate Sodium Tablet 100 MG(Last dose 1/6 8am), FLUoxetine HCl Capsule 20 MG(Last dose 8am), Lisinopril Tablet 10 MG(Last dose 1/6 8am), Melatonin Tablet 3 MG
Current Illness: Recent overall decline with generalized weakness, refusal of meals and medications, weight loss, and frequent falls. 1/5 Overall decline reviewed with APRN and ADPOA updated. 1/6-CBC WNL, BUN/Cr 55/1.93, GFR 24. Admitted to Hospice Services on 1/6. Covid Antigen Test negative on Jan 4th, 5th, 6th, 7th, 8th, & 9th. Covid positive on 1/10.
Preexisting Conditions: Dementia , Expressive aphasia, right-sided neglect and right sided weakness, high fall risk. S/P CEREBRAL INFARCTION DUE TO THROMBOSIS CORONARY ARTERY ANEURYSM ESSENTIAL (PRIMARY) HYPERTENSION PAROXYSMAL ATRIAL FIBRILLATION ABNORMAL RESULTS OF KIDNEY FUNCTION STUDIES CEREBRAL ANEURYSM, NONRUPTURED
Allergies: NKA
Diagnostic Lab Data: Covid positive on 1/10 without respiratory signs or symptoms. Considered recovered on 1/22 from acute illness.
CDC Split Type:

Write-up: Ongoing decline overall. Remained on Hospice with increased lethargy documented on 1/20/21 and progressively worsening thereafter.


VAERS ID: 1011929 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-21
Onset:2021-01-27
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029K20A / UNK AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Death, Dyspnoea, Dyspnoea exertional, Fatigue, Lethargy
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypercholesterolemia
Allergies: none
Diagnostic Lab Data: The coroners office has not confirmed with us a cause of death yet and continues to investigate her death. They have not shared with the family any results from medical or laboratory tests related to their post-mortem analysis.
CDC Split Type:

Write-up: Within a few days, my mother started reporting profound fatigue and shortness of breath while conducting routine household activities. She no longer had to energy for her daily exercise walks and became increasingly lethargic. She died in her sleep while taking an afternoon nap on Thursday, February 4th. I am highly concerned this could be a vaccine related.


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