|
VAERS ID: |
1247997 (history) |
Form: |
Version 2.0 |
Age: |
26.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 2021-04-16 |
Onset: | 2021-04-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-23 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EW0161 / 2 |
UN / SYR |
Administered by: Other Purchased by: ? Symptoms: Autopsy,
Chills,
Death,
Dizziness,
Malaise,
Nausea,
Vomiting SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-20
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: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: An autopsy is going to be done. See above for coroner information. I?m indicating below that he died, but I don?t know if the vaccine caused it or played a role. I?m filling this out as a concerned citizen wanting more investigation into this. Please speak to coroner for further information. CDC Split Type:
Write-up: Per his parents, patient started feeling nauseous an hour or two after the vaccine and at night around 10pm it worsened where he felt nauseous, had shivers and he vomited in the middle of the night. He then vomited again the next day and continued to not feel well the next couple of days. On 4/20/2021 at around 4:20pm he called his mother, his girlfriend and his mentor that he was not feeling well, was nauseous and dizzy and had shivers and was going to pull over on his car to get something to drink. He then stopped answering his phone and was found dead in his car later on that day. Police is investigating the case. |
|
VAERS ID: |
1258614 (history) |
Form: |
Version 2.0 |
Age: |
26.0 |
Sex: |
Female |
Location: |
Ohio |
Vaccinated: | 2021-04-01 |
Onset: | 2021-04-25 |
Days after vaccination: | 24 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
043A21A / UNK |
- / IM |
Administered by: Unknown Purchased by: ? Symptoms: Cardiac arrest,
Life support,
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), Noninfectious myocarditis/pericarditis (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-26
Days after onset: 1
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: Vienva Current Illness: Appendicitis, fall from 12 foot ladder resulting in fracture of olecranon process of left ulna requiring admission to skilled nursing facility Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Patient presented to ED for 2 syncopal episodes and went into cardiac arrest 5 minutes prior to ED arrival in ambulance. She received ACLS measures and alteplase was mixed and administered for pulmonary embolism concern. |
|
VAERS ID: |
1271212 (history) |
Form: |
Version 2.0 |
Age: |
29.0 |
Sex: |
Male |
Location: |
Puerto Rico |
Vaccinated: | 2021-04-12 |
Onset: | 2021-04-22 |
Days after vaccination: | 10 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-29 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / UNK |
- / - |
Administered by: Other Purchased by: ? Symptoms: Cardiogenic shock,
Death,
Echocardiogram,
Laboratory test SMQs:, Cardiac failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Noninfectious myocarditis/pericarditis (broad)
Life Threatening? Yes
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, 2 days
Extended hospital stay? No Previous Vaccinations: Other Medications: Clonazepam, Ambien, Transene Current Illness: Asma , Anxietyy Preexisting Conditions: On admission time was found with ejection fraction of 16% Allergies: NONE Diagnostic Lab Data: ECHO-CARDIOGRAM BLOOD TEST CDC Split Type:
Write-up: PATIENT DEVELOP CARDIOGENIC SHOCK AFTER RECEIVED FIRST DOSE OF MODERNA VACCINE ON THURSDAY 29 2021 PATIENT DIED |
|
VAERS ID: |
1273475 (history) |
Form: |
Version 2.0 |
Age: |
24.0 |
Sex: |
Female |
Location: |
Mississippi |
Vaccinated: | 2021-04-28 |
Onset: | 2021-04-29 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-30 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
016C21A / 1 |
RA / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Apnoea,
Death,
Pulse absent,
Resuscitation SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-29
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: Isosource Continuous feeding, Tylenol 650mg PRN; Ibuprofen 400mg PRN; Metoprolol 50mg BID Current Illness: Anoxic Brain Injury, History of MI, Uterine rupture, dysphagia, PEG TUBE, Tracheostomy Preexisting Conditions: Anoxic Brain Injury Allergies: NKA Diagnostic Lab Data: NA CDC Split Type:
Write-up: on 04/29/2021 Resident was checked at 1830 and found to be at baseline status. At approximately 1855, resident was found pulses and apneic. CPR initiated and resident transferred to medical center. Resident expired 1939. |
|
VAERS ID: |
1278030 (history) |
Form: |
Version 2.0 |
Age: |
27.0 |
Sex: |
Male |
Location: |
Virginia |
Vaccinated: | 2021-04-27 |
Onset: | 2021-04-30 |
Days after vaccination: | 3 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-01 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 2 |
UN / IM |
Administered by: Pharmacy Purchased by: ? Symptoms: Alanine aminotransferase increased,
Aspartate aminotransferase increased,
Blood creatine phosphokinase increased,
Blood lactic acid,
Blood pH increased,
Blood parathyroid hormone increased,
Cardiac arrest,
Cardiac failure,
Catheterisation cardiac normal,
Death,
Echocardiogram abnormal,
Ejection fraction normal,
Electrocardiogram ST segment elevation,
Endotracheal intubation,
Feeling abnormal,
Fibrin D dimer normal,
Haemodynamic instability,
Immunoglobulin therapy,
Life support,
Lung assist device therapy,
Nausea,
Pericardial effusion,
Pulse absent,
SARS-CoV-2 test negative,
Serum ferritin increased,
Therapeutic hypothermia,
Troponin,
Vomiting SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad), Noninfectious myocarditis/pericarditis (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-05-01
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: None Current Illness: None Preexisting Conditions: Down''s Syndrome Allergies: No known food or medication allergies Diagnostic Lab Data: COVID 19 not detected (4/30/21 at 21:40) D-dimer $g 20 (5/1/21 at 03:38) AST 7730 (5/1/21 at 03:38) ALT 7128 (5/1/21 at 03:38) Ferritin $g30,000 (5/1/21 at 03:38) Lactate $g 20 (5/1/21) PTH 680 (5/1/21) pH 7.26 (5/1/21 Troponin $g 50 (5/1/21 at 05:13) CK 2889 (5/1/21 at 05:13) Bedside ECHO 5/1/21 demonstrated good ejection (EF not reported). CDC Split Type:
Write-up: 27 year old male with Down''s Syndrome and no other past medical history received second COVID-19 vaccine on 4/27/2021. On 4/30/2021 began "feeling poorly" with nausea/vomiting and possible chest discomfort. Originally presented to ED on morning of 4/30 - EKG completed demonstrated diffused ST elevation. Patient was transferred to Medical Center for heart catheterization. Left heart catheterization demonstrated normal coronary arteries and LVEDP of 25. Stat ECHO demonstrated pericardial effusion and concern raised for myopericarditis. Patient subsequently transferred to a different Medical Center for higher level of care. Upon arrival to Medical Center plan was to intubate and take to cath lab for heart biopsy and PA catheter placement. However, upon intubation patient began to decompensate and subsequently developed cardiac arrest. During ACLS, VA ECMO was placed and therapeutic hypothermia was initiated. Following VA ECMO placement patient received IVIG, high dose methylprednisolone (1000 mg), anakinra 100 mg, and broad spectrum antibiotics (vancomycin and Zosyn). Despite these efforts the patient continued to have hemodynamic instability and was on high dose vasopressors (epinephrine, norepinephrine, dopamine, angiotensin II, vasopressin). Patient subsequently suffered another cardiac arrest, briefly regained pulse with high dose vasopressors, but subsequently lost pulse despite best efforts and died on 5/1/2021 at approximately 13:00. |
|
VAERS ID: |
1286275 (history) |
Form: |
Version 2.0 |
Age: |
26.0 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 2021-04-12 |
Onset: | 2021-04-01 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-04 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
- / 1 |
UN / SYR |
Administered by: Pharmacy Purchased by: ? Symptoms: Death,
Subarachnoid haemorrhage SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-21
Days after onset: 20
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: Obesity Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Death due to a Subarachnoid hemorrhage |
|
VAERS ID: |
1302844 (history) |
Form: |
Version 2.0 |
Age: |
29.0 |
Sex: |
Male |
Location: |
Texas |
Vaccinated: | 2021-05-06 |
Onset: | 2021-05-07 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-10 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
026C21A / 2 |
- / SYR |
Administered by: Private Purchased by: ? Symptoms: Abdominal pain,
Autopsy,
Chest pain,
Death,
Dyspnoea,
Lethargy SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-05-09
Days after onset: 2
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Hydroxyzine pamoate Current Illness: Preexisting Conditions: Hypertension, non-insulin dependent diabetes Allergies: None Diagnostic Lab Data: Autopsy on May 10, 2021. Results pending. CDC Split Type:
Write-up: Lethargy began the day of vaccine and shortness of breath along with abdominal and chest pain followed the next day. Decedent was found deceased the next evening. |
|
VAERS ID: |
1321517 (history) |
Form: |
Version 2.0 |
Age: |
23.0 |
Sex: |
Male |
Location: |
Puerto Rico |
Vaccinated: | 2021-04-30 |
Onset: | 2021-05-01 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EW0175 / 1 |
AR / SYR |
Administered by: Unknown Purchased by: ? Symptoms: Death SMQs:
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-05-01
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: He used to take Tylenol for headaches and melatonin ocassionally to sleep. Dont know if he had it the day of vaccine or the day he died. Current Illness: No Preexisting Conditions: No Allergies: No Diagnostic Lab Data: CDC Split Type:
Write-up: He did not told me about any symptoms. He just died the next day of the vaccine. Still today doesn?t know why he died. He appeared to be in good health. |
|
VAERS ID: |
2624451 (history) |
Form: |
Version 2.0 |
Age: |
22.0 |
Sex: |
Female |
Location: |
Kentucky |
Vaccinated: | 2021-03-19 |
Onset: | 2021-04-14 |
Days after vaccination: | 26 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-18 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
032M20A / 1 |
RA / IM |
Administered by: Public Purchased by: ? Symptoms: Condition aggravated,
Hypopnoea,
Muscle twitching SMQs:, Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (narrow), Respiratory failure (narrow)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-04
Days after onset: 10
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: CLONAZEPAM, TRILEPTAL, GAVAPENTIN, GLYCOPYRROLATE Current Illness: TRAMATIC BRAIN INJURY AT 1 YEAR OLD Preexisting Conditions: PCP ANNUAL EXAM 1 WK PRIOR TO VACCINE. PT WHEELCHAIR BOUND, TRACH, O2 Allergies: NKDA Diagnostic Lab Data: NONE CDC Split Type:
Write-up: NURSE GAVE VACCINE OUTSIDE IN PATIENT VAN WITH MOM AND BROTHER PRESENT. PT TOLERATED VACCINE WELL. PT WAITED ON SITE FOR 15 MIN. AFTER VACCINE WITHOUT ISSUES. MOM STATES DAYS FOLLOWING VACCINE PT MAY HAVE HAD SOME FACIAL TWITCHING AND SHALLOW BREATHING. UNSURE BECAUSE SHALLOW BREATHING WAS NORMAL FOR PATIENT. GAVE MOM NUMBER TO REPORT INCIDENT. |
|
VAERS ID: |
1334527 (history) |
Form: |
Version 2.0 |
Age: |
28.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 2021-05-04 |
Onset: | 2021-05-10 |
Days after vaccination: | 6 |
Submitted: |
0000-00-00 |
Entered: |
2021-05-20 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EW0173 / 2 |
- / - |
Administered by: School Purchased by: ? Symptoms: Abnormal behaviour,
Blood potassium decreased,
Blood test abnormal,
Computerised tomogram,
Cough,
Death,
Dyspnoea,
Echocardiogram,
Haemoptysis,
Heart rate increased,
Infection,
Malaise,
Mobility decreased,
Pallor,
Pulmonary oedema,
SARS-CoV-2 test negative SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (narrow), COVID-19 (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-05-15
Days after onset: 5
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
Extended hospital stay? No Previous Vaccinations: Other Medications: No Current Illness: may be high blood pressure Preexisting Conditions: No Allergies: Seasonal allergies only Diagnostic Lab Data: Yes, blood work, ECHO, CAT, and Covid test that was negative, potassium was low, HR was elevated to 200bpm Blood work showed infection. CDC Split Type:
Write-up: My brother got the Pfizer 5/4 and started getting sick with a cough on the 7th and by the 10th he was getting more and more sick and ye was taken to the ER on the 14th and he started coughing up blood, he was out of it and pale and not able to move much. On 5/15 in the hospital he was having a hard time breathing and they were trying to give him meds to make him better, they gave him antibiotics because his blood work showed infection, and Precedex to help him rest, and he passed away the same day, he was in good health before. They also said his heart rate was 201/123 and the doctors said pulmonary anema. It escalated so quickly. |
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