The VAERS (Vaccine Adverse Event Reporting System) is used to detect
problems that are due to vaccines. The VAERS site is very specific
about cautioning against taking these reports to imply causality;
however, the people who monitor these reports consider background
adverse events and an acceptable level of adverse events that are
caused by the vaccines. What is disturbing is that we are not being
given information of possible adverse events. This table is the first
300 deaths out of over 4000 reported deaths taken
directly from the CDC data
set available at https://vaers.hhs.gov/data/datasets.html?
To download the whole 4000 row spreadsheet, click here.
| VAERS_ID | RECVDATE | STATE | AGE_YRS | SEX | SYMPTOM_TEXT | DATE DIED | VAX_DATE | ONSET_DATE | NUMDAYS |
| 1166062 | 4/4/2021 | 0.42 | M | Patient received second dose of Pfizer vaccine on March 17, 2020 while at work. March 18, 2020 her 5 month old breastfed infant developed a rash and within 24 hours was inconsolable, refusing to eat, and developed a fever. Patient brought baby to local ER where assessments were performed, blood analysis revealed elevated liver enzymes. Infant was hospitalized but continued to decline and passed away. Diagnosis of TTP. No known allergies. No new exposures aside from the mother's vaccination the previous day. | 3/20/2021 | 3/17/2021 | 3/18/2021 | 1 | |
| 1261766 | 4/27/2021 | FL | 1 | M | increased body temperature, seizure, death | 4/10/2021 | 4/8/2021 | 4/10/2021 | 2 |
| 1255745 | 4/25/2021 | VA | 2 | F | she was going to die/dies after vaccine; 2-year-old patient; This is a spontaneous report from a non-contactable consumer via a Pfizer-sponsored program. A 2-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), second dose at the age of 2-years-old via an unspecified route of administration on 25Feb2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history and concomitant medications were not reported. It was reported that the 2-year-old dies after vaccine on 03Mar2021. Reported on VAERS. Look for the researchers to exclude her from the study, probably claiming her death had nothing to do with the shot, she was going to die that day, five days after vaccination anyway. That's how they roll. The patient died on 03Mar2021. The outcome of the event was fatal. No follow-up attempts are possible. Information on lot/batch cannot be obtained. No further information is expected.; Reported Cause(s) of Death: she was going to die | 3/3/2021 | 2/25/2021 | 2/25/2021 | 0 |
| 1187918 | 4/9/2021 | NH | 15 | F | I do not know the exact date of the first or second Moderna Vaccine. I am the PICU attending who cared for the patient after her cardiac arrest which we believe was about 3-4 days after her second Moderna Vaccine | 4/6/2021 | 4/5/2021 | ||
| 1242573 | 4/22/2021 | CO | 15 | M | Heart failure | 4/20/2021 | 4/18/2021 | 4/19/2021 | 1 |
| 1225942 | 4/18/2021 | WI | 16 | F | Patient was a 16yr female who received Pfizer vaccine 3/19/21 at vaccine clinic and presented with ongoing CPR to the ED 3/28/21 after cardiac arrest at home. Patient placed on ECMO and imaging revealed bilateral large pulmonary embolism as likely etiology of arrest. Risk factors included oral contraceptive use. Labs have since confirmed absence of Factor V leiden or prothrombin gene mutation. Patient declared dead by neurologic criteria 3/30/21. | 3/30/2021 | 3/19/2021 | 3/28/2021 | 9 |
| 1199455 | 4/12/2021 | WI | 17 | F | Patient reported difficulty breathing and chest pain; suffered cardiac arrest and death | 4/10/2021 | 4/2/2021 | 4/10/2021 | 8 |
| 1243487 | 4/22/2021 | MI | 17 | M | Patient Committed Suicide with a firearm. | 4/21/2021 | 4/13/2021 | 4/21/2021 | 8 |
| 1307657 | 5/11/2021 | OH | 17 | M | Death by suicide. | 4/23/2021 | 4/19/2021 | 4/23/2021 | 4 |
| 1078352 | 3/6/2021 | IL | 18 | M | Developed fatigue, body aches, headache 1 day after vaccination on 3/3. The morning of 3/5 complained of chest pain. Took Tylenol at 8:30 am. At 10:30 am his family found him unresponsive. EMS was called and he was pronounced dead in the home. | 3/5/2021 | 3/2/2021 | 3/5/2021 | 3 |
| 1105115 | 3/16/2021 | PR | 18 | M | Resident did not express having any symptoms, the only thing that the POC observed abscesses in the arm, groin, thigh and knees after the first vaccination. After the second dose, he was hypoactive. On 2/27 at about 3:30 am he asked him to turn on his side, between 4 am and 5 am POC went to the room I notice it strange, because his head was wrapped in the sheet. When the POC removed the sheet, she observed that her mouth and nose were full of secretions. So he turned it and he himself did not react. He called the emergency who certifies that he had no vital signs. (emergency arrives within 5:45 am to 6:00 am) | 2/28/2021 | 2/14/2021 | 2/18/2021 | 4 |
| 1209903 | 4/14/2021 | NJ | 19 | F | I DON'T KNOW THE EXACT EVENTS FOR THE CASE, BUT WAS ASKED TO FILL IN THE INFORMATION THE BEST I COULD WITH THE INFORMATION I HAD ON HAND. THIS YOUNG LADY, RECEIVED A COVID-19 VACCINE ON 3/6/2021 AND EXPIRED ON MARCH 13, 2021. THIS IS MOST OF THE INFORMATION THAT I HAVE. YOU WOULD NEED TO CONTACT THE MEDICAL EXAMINER'S OFFICE, THAT WILL BE ABEL TO PROVIDE YOU WITH MOST DETAIL FOR THIS CASE. | 3/13/2021 | 3/6/2021 | 3/13/2021 | 7 |
| 1121695 | 3/22/2021 | CA | 21 | M | The patient, who has no significant past medical history including diabetes, presented with very severe diabetic ketoacidosis one week after receiving the vaccine. He developed severe metabolic encephalopathy, aspiration pneumonia, and was placed on mechanical ventilation. At the time of this reporting, he is brain death (awaiting apnea test confirmation). He is expected not to survive. | 3/1/2021 | 3/10/2021 | 3/10/2021 | 0 |
| 1140258 | 3/27/2021 | NY | 21 | F | Patient contacted 911 complaining of not feeling well and difficulty breathing. Upon arrival patient was found by EMS in cardiac arrest. EMS was unable to get return of spontaneous circulation. | 3/27/2021 | 3/26/2021 | 3/27/2021 | 1 |
| 1198540 | 4/12/2021 | CA | 21 | M | Unknown if the vaccine has any correlation to event. Patient was found unresponsive and not breathing on 4/11/21 @ approximately 3:45 PM outside on the grounds of the campus. A rented scoter was next to him. There was no sign of trauma. 9-1-1 was called and CPR initiated by passerby (there were no witnesses). He remained unresponsive and was intubated when the paramedics arrived. He was transported to hospital where he was pronounced dead. | 4/11/2021 | 4/1/2021 | 4/11/2021 | 10 |
| 1206323 | 4/14/2021 | OH | 21 | M | Pt received vaccine at 1130 on 4/10. Per report of others reported feeling fine at 2300 4/10. Went to bed. Awoke at approx 0100 4/11, reported not feeling well, vomited, returned to bed. Found by housemate at appox 2100 4/11 unresponsive. Declared deceased with rigor mortis by EMS. Pt in custody of the coroner for autopsy. | 4/10/2021 | 4/11/2021 | 1 | |
| 1243791 | 4/22/2021 | VA | 21 | M | Per the father, the deceased received his first shot of Moderna vaccine on Saturday, 4/10/2021 at a local church. He did not work on 4/11/2021. Worked on 4/12/2021. The deceased was found dead at 6:43 p.m. at his home. | 4/12/2021 | 4/10/2021 | 4/12/2021 | 2 |
| 1076949 | 3/5/2021 | OR | 22 | F | Patient admitted on 2/21/21 and died in hospital on 2/22/2021. Patient had a significant, lifelong underlying medical condition. | 2/22/2021 | 1/29/2021 | 2/22/2021 | 24 |
| 960841 | 1/21/2021 | NY | 23 | M | Patient developed 104.4 temp approximately 48 hours after being given the vaccine. I treated him with antibiotics, IV fluids, cooling methods. CXR does show a new right perihilar infiltrate. However, his fever came down within the next 24-48 hours. Unfortunately, he suffered a cardiac arrest on 1/21/21 in the early morning and expired. | 1/21/2021 | 1/17/2021 | 1/19/2021 | 2 |
| 1105146 | 3/16/2021 | PR | 23 | M | 1/19 began vomiting and was hospitalized. On 1/30 he was discharged and later received the vaccine. It begins with weakness and a lack of appetite. He started coughing up foul-smelling secretions. He makes the arrangements to take him to the emergency room again, he called 911 to be transported, when they are taking the information from the POC, he is under oxygenation to 44. They take him in the ambulance, he receives CPR, they transport him to the facility where he arrives lifeless. | 2/2/2021 | 1/30/2021 | 1/30/2021 | 0 |
| 1204016 | 4/13/2021 | ID | 23 | M | HE DIED SUDDENLY !!!!! JUST COLLAPSED !!!! | 4/13/2021 | 4/9/2021 | 4/13/2021 | 4 |
| 1074788 | 3/5/2021 | 24 | F | At 8 weeks pregnancy (2 weeks after first shot) started bleeding and had a subchorionic hematoma. By 10 week subchorionic hematoma resolved. Received second shot and of Feb. 1 week later, at 12 weeks pregnancy , fetus had no heart beat! It measured normal size (as expected) and limited normal first trimester anatomy by ultrasound. But NO heart beat. Something insulted this placenta to lead to fetal demise. | 2/1/2021 | 3/4/2021 | 31 | ||
| 1273475 | 4/30/2021 | MS | 24 | F | 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. | 4/29/2021 | 4/28/2021 | 4/29/2021 | 1 |
| 936805 | 1/12/2021 | KY | 25 | M | Patient received the vaccine on 12/22/20 without complication. It was reported today that the patient was found unresponsive and subsequently expired at home on 1/11/21. | 1/11/2021 | 12/22/2020 | 1/11/2021 | 20 |
| 1033873 | 2/16/2021 | IL | 25 | F | PATIENT PASSED AWAY ON 2-1-2021 | 2/1/2021 | 1/20/2021 | 2/1/2021 | 12 |
| 1168641 | 4/5/2021 | FL | 26 | M | Death. | 2/26/2021 | 2/25/2021 | 2/26/2021 | 1 |
| 1237709 | 4/21/2021 | IA | 26 | M | Patient deceased | 4/20/2021 | 4/19/2021 | 4/20/2021 | 1 |
| 1247997 | 4/23/2021 | CA | 26 | M | 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. | 4/20/2021 | 4/16/2021 | 4/16/2021 | 0 |
| 1258614 | 4/26/2021 | OH | 26 | F | 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. | 4/26/2021 | 4/1/2021 | 4/25/2021 | 24 |
| 1286275 | 5/4/2021 | NJ | 26 | F | Death due to a Subarachnoid hemorrhage | 4/21/2021 | 4/12/2021 | 4/1/2021 | |
| 1160526 | 4/2/2021 | PA | 27 | F | Death 5 hours after second shot. Decedent contacted her mother around 3:30 c/o difficulty breathing. Died on 4/1/20 | 4/1/2021 | 4/1/2021 | 0 | |
| 1177058 | 4/7/2021 | MT | 27 | F | Family reports that patient had her 2nd dose of COVID-19 vaccine on 4/1, approximately 3 weeks after her first dose. Patient had one week history of "allergy type" symptoms. Evening of 4/1 developed "GI symptoms and diarrhea". Morning of 4/2 her "neighbor came by to check on her and she stated that she was not feeling very well last night but thought she just needed some Gatorade of something...He stated that as he gave her the alka-Seltzer he told her that there was aspirin in it which apparently she has an allergy to. He stated that her response was I should be fine I do not think I'm that allergic to aspirin...5 to 10 minutes later she started to have some issues...Patient stated to her neighbor that she was having a hard time breathing and thought she needed to go to the hospital, and that maybe she was more allergic to the aspirin than she had thought...Over the 15 miles between her house and the hospital patient condition deteriorated to the point where they arrived at the hospital she is in full cardiac arrest...given ACLS protocol including epinephrine and was intubated." "They achieved ROSC after approximately 10 minutes." Patient was then flown, MT emergency department to Hospital. Patient was cared for in the ICU. Patient herniated her brain the night of 4/5-4/6. "After meeting the clinical and imaging criteria at 1605 on 4/6/2021 she was declared brain dead. Medical team suggests that patient had Samter's Triad/Triad Asthma with history of asthma, nasal polyps and allergy to aspirin. Anaphylaxis secondary to ingestion of aspirin via Alka-Seltzer. | 4/6/2021 | 4/1/2021 | 4/2/2021 | 1 |
| 1206330 | 4/14/2021 | IL | 27 | M | Death | 4/12/2021 | 4/11/2021 | 4/12/2021 | 1 |
| 1243832 | 4/22/2021 | NC | 27 | F | 4.21.2021- I spoke with (patient's husband) related to spouse. Husband stated the patient has a history of 2nd Degree Type 2 heart block, pacemaker placed at the age of 14, and she currently has issues with an eating disorder dx with anorexia. Patient is reported to be approximately 68-70 pounds at the time of vaccination. March 8.2021- Husband states he and his wife came to receive the vaccine around 1630. After, receiving the vaccine the patient stated to her Husband "my arm really hurts." She begin experiencing s/s at approximately 1900 including: fever, chills, runny nose, fatigued and tired - reportedly temperature was 100.0 and the patient began to drink Gatorade and take Tylenol. Monday, 3.15.2021 patient continued to have symptoms therefore, (husband) contacted Moderna Representatives from the safety team, to determine if it would be safe for the patient to get the 2nd vaccine dose - advised everyone that does not have contraindications should be vaccinated-advised to reach out to PCP. Husband stated that the patient did not want to go to her PCP because of her eating disorder. The patient worked from bed during the week per the husband and spent 90-95% of her time in the bed after receiving the vaccine. Husband states on Saturday 3.20.2021 the patients fever had subsided however, she continued to feel poorly and remained bedbound most of the time. Husband is an Pilot 3.23.2021 stated once, he had landed he began trying to contact wife but she was not answering the phone, after several attempts to contact wife - Husband called a neighbor to check on wife. Upon, entering the residence the neighbor found wife lying on the floor unconscious and not breathing. The neighbor notified Husband and called 911. EMS arrived at the scene and pronounced the patient as a DOA. Husband states that the death certification list cardiac arrest, electrolyte imbalance, and heart block, as causes for death. Husband is concerned that the vaccine may have contributed in some way demise of his wife as he stated "she was never the same after the vaccination." | 3/23/2021 | 3/8/2021 | 3/8/2021 | 0 |
| 1278030 | 5/1/2021 | VA | 27 | M | 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. | 5/1/2021 | 4/27/2021 | 4/30/2021 | 3 |
| 943397 | 1/14/2021 | NJ | 28 | M | On day due for 2nd dose, Patient was found unresponsive at work in the hospital. Patient pupils were fixed and dilated. Full ACLS was initiated for 55 minutes with multiple rounds of bicarb, calcium chloride, magnesium, and epinephrine. Patient was intubated. Patient continued into V. Fib arrest and was shocked multiple times. | 1/11/2021 | 12/23/2020 | 1/11/2021 | 19 |
| 1034146 | 2/16/2021 | AZ | 28 | M | ARRIVED AT EVENT, CONSENT FORM COMPLETED, DID NOT REPORT HE HAD BEEN ILL, DID NOT REPORT THAT HE TOOK ANY FEVER REDUCING MEDICATIONS | 2/1/2021 | 2/13/2021 | 2/14/2021 | 1 |
| 1071935 | 3/4/2021 | IA | 28 | M | Patient received the vaccine around 11 am. He hadn't been feeling well (headache, dizziness) per report and initially called in to work. He then decided to come to work and was found down in a patient bathroom during his shift on our Facility while taking care of a patient (he was a nurse aid). Patient was coded and the team and was transferred to our Facility ED. He expired 3/3 2112 | 3/3/2021 | 3/3/2021 | 3/3/2021 | 0 |
| 1082804 | 3/8/2021 | AZ | 28 | M | Patient committed suicide the morning of March 2, 2021. He stepped in front of a truck on a highway. I consulted with pharmacy and they said that I should report even if the 2 most likely have nothing to do with each other. | 3/2/2021 | 2/18/2021 | 3/2/2021 | 12 |
| 1088723 | 3/10/2021 | TX | 28 | M | Patient had 2nd COVID vaccine on 2/21/2021. He started having a temperature on 2/24/2021. Patient then started having trouble breathing. We took him to hospital. He was admitted on 2/25/2021. He steadily declined and was sent to ICU and died on March 1, 2021. | 3/1/2021 | 2/21/2021 | 2/24/2021 | 3 |
| 1129860 | 3/24/2021 | 28 | F | Died January 21 after she received an mRNA shot; A spontaneous report was received from a consumer via social media concerning a 28-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and died two days later (death). The patient's medical history was not provided. No relevant concomitant medications were reported. On 19 Jan 2021, per social media post, the patient received one of their two planned doses of mRNA-1273 (Batch number not provided) intramuscularly for prophylaxis of COVID-19 infection. The reporter stated that the patient was dead on 21 Jan 2021. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not applicable. The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was done. The reporter stated that the autopsy showed no other red flags, otherwise, no additional autopsy results were reported.; Reporter's Comments: Very limited information regarding this event has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death | 1/21/2021 | 1/19/2021 | 1/21/2021 | 2 | |
| 1145918 | 3/29/2021 | IN | 28 | F | As reported by the patient's mother, the patient received the vaccine on 1/19/21, "got sick" on 1/20/21, and died in the early morning hours of 1/21/21. No further information was offered. | 1/21/2021 | 1/19/2021 | 1/20/2021 | 1 |
| 1159535 | 4/2/2021 | AZ | 29 | F | Patient described myalgias, headache and dyspnea at ER visit on 4/1/21 at 2:37 am. Patient was discharged. Patient returned the same day at 15:40 cyanotic, altered, hypoxic and hypotensive. The patient was found to have profound metabolic acidosis, liver failure, renal failure. She went into cardiopulmonary arrest, was revived, rearrested and died. Patient was treated for possible sepsis, shock, liver failure. | 4/1/2021 | 3/31/2021 | 3/31/2021 | 0 |
| 1224177 | 4/18/2021 | GA | 29 | F | Blood clot blocking blood flow to brain - 1st episode: ( 3/12/21) stabilized, minor limited movement left side - 2nd episode: (3/24/21) no blood flow to brain, death (maintained on life support for organ donation) | 3/19/2021 | 2/24/2021 | 3/12/2021 | 16 |
| 1302844 | 5/10/2021 | TX | 29 | M | 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. | 5/9/2021 | 5/6/2021 | 5/7/2021 | 1 |
| 1101884 | 3/15/2021 | NM | 30 | F | History, patient received 1st COVID-19 Pfizer vaccine on 1/28/21 and 2nd Pfizer COVID-19 vaccine on 2/17/21 Unsure if any relation but patient was treated in our urgent care on 3/8/2021 18 day post receipt of 2nd COVID-19 vaccine unresponsive. Patient received ACLS support for unknown cause with suspected neurological/respiratory/cardiac complications. Patient was transferred to higher level of care. | 3/10/2021 | 2/17/2021 | 2/17/2021 | 0 |
| 1223941 | 4/17/2021 | FL | 30 | M | Death 4/17/21 | 4/17/2021 | 4/9/2021 | 4/17/2021 | 8 |
| 1124794 | 3/22/2021 | NY | 31 | M | Extreme head ache, chest pain, fever 101 F. Gave 1000 mg Tylenol, albuterol via nebulizer Q4hr. Died 3/20/2021 approx 11:00 am from Cardiac Arrest. | 3/20/2021 | 3/17/2021 | 3/17/2021 | 0 |
| 1212820 | 4/15/2021 | CA | 31 | M | Unexpected death 3 days after vaccination | 4/13/2021 | 4/10/2021 | 4/13/2021 | 3 |
| 939050 | 1/12/2021 | NY | 32 | F | Patient vaccinated on 12/28. Approximately one day later, develops cough and on azithromycin x 1 week. On 1/3, patient develops left-sided weakness and aphasia. Taken to the hospital, tested COVID+, required intubation -- acute hypoxic respiratory failure secondary to COVID - on H&P. Patient died on 1/4/21 at 7:20am. | 1/4/2021 | 12/28/2020 | 12/29/2020 | 1 |
| 1026362 | 2/12/2021 | PA | 32 | M | Patient stated he had a migraine after the vaccine. We were advised of a change in appetite on Thursday February 4th. Patient died on February 6th. | 2/6/2021 | 1/1/2021 | 2/4/2021 | 34 |
| 1098028 | 3/14/2021 | NY | 32 | M | Cardiac arrest, death approx 12 hours later | 3/14/2021 | 3/13/2021 | 3/14/2021 | 1 |
| 1232541 | 4/20/2021 | NJ | 32 | M | Patient found unresponsive at approximately 12:00 am 10/11. EMS called and patient was pronounced dead at scene. | 4/11/2021 | 4/10/2021 | 4/11/2021 | 1 |
| 1237092 | 4/21/2021 | MI | 32 | M | Massive pulmonary thromboemboli | 4/19/2021 | 4/10/2021 | 4/14/2021 | 4 |
| 1243648 | 4/22/2021 | NY | 32 | M | headache on 4/8/21, sudden death 4/11/2021 | 4/11/2021 | 4/7/2021 | 4/8/2021 | 1 |
| 1293909 | 5/6/2021 | CA | 32 | F | Per family, pt reported fatigue and elevated glucose, nausea and diarrhea 3-4 days after immunization. She was seen by her PCP following week and again was experiencing elevated blood glucose. | 5/1/2021 | 4/20/2021 | 4/23/2021 | 3 |
| 986901 | 1/29/2021 | NC | 33 | F | Patient received vaccine uneventfully with no acute concerns. Left clinic and by report went out with friends. Spoke to father on phone at or around 9:00 pm. Failed to show up to work and was found dead at home. Other details pending | 1/29/2021 | 1/28/2021 | 1/28/2021 | 0 |
| 1154126 | 4/1/2021 | CA | 33 | M | Diabetic ketoacidosis; This is a spontaneous report from a contactable consumer. A contactable consumer reported for her nephew. A 33-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (at the age of 33-years-old) at single dose for covid-19 immunisation. Medical history included type 1 diabetes mellitus from an unknown date and unknown if ongoing, impaired gastric emptying from an unknown date and unknown if ongoing, ulcer from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient experienced diabetic ketoacidosis on an unspecified date. The patient died on 21Mar2021 due to diabetic ketoacidosis. An autopsy was not performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Diabetic ketoacidosis | 3/21/2021 | |||
| 1177548 | 4/7/2021 | CA | 33 | F | On the evening of 4/3/2021 the patient was at home, prone in bed, gasped suddenly and became unresponsive. EMS was called and unable to resuscitate. She expired. | 4/3/2021 | 4/3/2021 | 4/3/2021 | 0 |
| 1198157 | 4/12/2021 | 33 | F | Hospice patient death within 60 days of receiving the COVID vaccine series | 4/7/2021 | 2/27/2021 | 4/7/2021 | 39 | |
| 1200959 | 4/13/2021 | 33 | M | death | 4/5/2021 | 4/5/2021 | 4/5/2021 | 0 | |
| 1228010 | 4/16/2021 | 33 | M | Death Narrative: Patient was not previously Covid positive and did not have any predisposing factors(PMH, allergies, etc.) for experiencing an adverse drug event. The ADR did not occur at the time of administration of the vaccine nor was there an ADR that occurred between the observation period and the date of death. Patient died of a drug overdose and had a UDS positive for fentanyl and alcohol on 3/8/21 patient tested positive for Chlamydia due to high risk sexual behavior and substance use disorder. Patient was admitted to facility on 2/26/21 to detox from alcohol. | 3/17/2021 | 3/8/2021 | 3/17/2021 | 9 | |
| 1242117 | 4/22/2021 | CO | 33 | M | Healthy male, no substance use, no symptoms reported made plans to go hiking with a friend the following Sunday (4/18/21) on 4/16/2021 in afternoon. This was last known contact, patient stopped responding to phone after text and was found deceased in home on 4/22/2021, appearing to have passed away in sleep, likely 4/16/2021 in evening. | 4/16/2021 | 4/9/2021 | 4/16/2021 | 7 |
| 1246604 | 4/23/2021 | LA | 33 | M | Patient presented to ED on 04/18/2021 with cardiopulmonary arrest, per ED "He was receiving CPR with EMS for arrival to the emergency. Two rounds epi. Asystole and then went into V-tach. Got shocked once. Then after that has been strip PA asystole." ED called time of death on patient 04/18/2021 at 05:14AM. | 4/18/2021 | 4/6/2021 | 4/18/2021 | 12 |
| 1296030 | 5/7/2021 | NV | 33 | M | Unknown cardiac event. Found on sidewalk down. Revived but resulted in extensive neurological damage. Was put in life support. Never came to. Passed away 05/05/2021. | 5/1/2021 | 4/25/2021 | 4/25/2021 | 0 |
| 1198211 | 4/12/2021 | WI | 34 | M | The patient received his 2nd dose of Moderna (LOT#, site, time unavailable) at an outside clinic the morning of 2/10/21 and presented to the ED with coughing and hypoxia (sp02 occasionally dropping into 70's) at 8 PM that day. He had quadriplegic spinal paralysis as a result of a remote MVA and has been hospitalized and critically ill in the past due to recurrent UTI's and pneumonia with associated sepsis. CT negative for pulmonary embolism and showed bilateral infiltrates. Clinical presentation consistent with bilateral pneumonia and started on Rocephin/azithromycin. He was initially stable in the hospital on 1-2 LPM 02. The following evening he became febrile and acutely developed asystole without any pre-existing arrhythmia. Resuscitation was attempted for 45 minutes but unsuccessful. Overall, I suspect his death was related to bacterial pneumonia and resulting acute respiratory failure, complicated by his quadriplegia and autonomic dysreflexia but reported this event as it did occur within 2 days of receiving his 2nd Moderna vaccination. | 2/11/2021 | 2/10/2021 | 2/10/2021 | 0 |
| 1267278 | 4/28/2021 | CA | 34 | M | Patient passed away 4/12/2021 suddenly, found by family on couch. Was having shortness of breath day before. Per mom, patient had been laughing and talking the morning before patient passed away. | 4/12/2021 | 4/10/2021 | 4/11/2021 | 1 |
| 1293657 | 5/6/2021 | CA | 34 | M | 34 y/o male with no PMHx presenting in cardiac arrest from home. Per pt's wife, he received 2nd dose of the Pfizer vaccine roughly 24 hours prior. He complained of arm soreness yesterday afternoon and some chills this morning, took Tylenol for these symptoms. She found him unresponsive in bed after speaking to him roughly 2 hours earlier. Per EMS, patient was in asystole upon their arrival. He received ~ 30 minutes of prehospital ACLS and an additional 20 minutes in the ED and remained in asystole throughout. | 5/6/2021 | 5/5/2021 | 5/6/2021 | 1 |
| 1306986 | 5/11/2021 | NC | 34 | M | Patient expired of probable aneurysm at Hospital on 5/10/2021 | 5/10/2021 | 5/7/2021 | 5/10/2021 | 3 |
| 1104175 | 3/16/2021 | MD | 35 | F | She received the 2nd Dose on 3/9/2021. On 3/10/2021 She complained of a headache. On the morning of 3/11/2021 she complained of abdominal pain and had no appetite. We then found her unresponsive, called 911 and the medics pronounced her at around 1300. | 3/11/2021 | 3/9/2021 | 3/11/2021 | 2 |
| 1201114 | 4/13/2021 | GA | 35 | F | Due date 4/18/2021. Pt presented in labor on 4/10/21. Her labor was uncomplicated and progressing appropriately. She had sudden onset of coughing following by loss of consciousness. Code blue was called. Emergency bedside C/S was performed. Despite resuscitative efforts of 1 hour and 15 minutes, the patient expired. | 4/10/2021 | 4/2/2021 | 4/10/2021 | 8 |
| 1228351 | 4/19/2021 | NC | 35 | M | He died unexpectedly early in the morning. He woke up suddenly, said he needed help, and then was gone. | 3/8/2021 | 3/4/2021 | 3/8/2021 | 4 |
| 1242520 | 4/22/2021 | KS | 35 | F | 35 y/o with asthma (on alvesco and singulair), GERD, morbid obesity (BMI 45) and RA (on prednisone and MTX, SZA.) Vaccinated for COVID 2.12. and 3.10 Recent lab 3/17- normal, including negative CRP. Code continued for 50 minutes, no shock advised. PEA, gave Epi X 4. Normal BS. Considered narcan. Over the weekend- 4/17 Chest pain that started with eating. Labile blood pressure. EKG showed NSR rate 64. Treated with ASA 325, clear liquid diet and rest. Treated with toradol and Zofran. Improved. At f/u on Monday, discussed chronic knee pain was overall better. Normal for her exam. BP 136/79. Felt dizzy and then passed out, hitting her head, became pulseless an apneic and was coded for over an hour. | 4/19/2021 | 3/10/2021 | 4/17/2021 | 38 |
| 1281531 | 5/3/2021 | TX | 35 | M | Received 2nd dose of vaccine, 5 days later his left leg started hurting and swelling. He had severe headache afterwards, dizzy and blurred vision. 04/24/2021 he complained of not feeling right, coughed and passed out. Had fever and chills when he came to. Wife called 911 and was talking and walking. Was awake and talking in ambulance, oxygen level was low. Once arrived at hospital, he became restless and passed away within 3 minutes. Autopsy was performed due to his age - 35 and no pre-existing illnesses - was determined he died of Pulmonary Thrumbo Embolism | 4/24/2021 | 4/5/2021 | 4/12/2021 | 7 |
| 1312456 | 5/12/2021 | IA | 35 | M | Death. While driving patient passed out and was found by County Sheriffs Office. EMT was called and could not save patient. M.E. Declared patient dead at 7:20 PM on May 4, 2021 | 5/4/2021 | 5/3/2021 | 5/4/2021 | 1 |
| 1313922 | 5/13/2021 | MI | 35 | M | PT NO SHOW FOR APPT 5/11 FOR 2ND DOSE -CHECK OF agency system SHOWS PT REPORTED DECEASED 5/14- CHECK OF database SHOWS PT FOUND DECEASED AT HOMEN 5/14/21- AUTOPSY Completed | 4/15/2021 | 4/13/2021 | 4/15/2021 | 2 |
| 1054160 | 2/25/2021 | IL | 36 | M | 2/12/2021 woke up with sore arm and back. 2/13/2021 woke up with headache around 1am. Headache and nausea all morning. Mid-late afternoon started having seizures. Admitted to Hospital 2/15/2021 expired. Reported per wife on 2/25/2021. | 2/15/2021 | 2/11/2021 | 2/12/2021 | 1 |
| 1176010 | 4/7/2021 | NY | 36 | M | He got his vaccine, and mother had talked to his girlfriend said that he felt fine other than a sore arm. He called his mother and told her that he was sick to his stomach with cramps and that he was throwing up blood. The girlfriend found him on the floor on the 21st dead on the floor in his hotel room at 8:00 AM. The girlfriend said she had spoken with him around 10:00 PM and that he said he was going to sleep on the floor in the bathroom as he was throwing up and the floor was cool. She subsequently found out that he was throwing up blood, and autopsy report showed that his stomach was full of blood and further testing is being done to see what has caused the bleeding. | 3/21/2021 | 3/10/2021 | 3/18/2021 | 8 |
| 1203510 | 4/13/2021 | CO | 36 | M | Unknown on any adverse events or symptoms | 4/11/2021 | 4/9/2021 | 4/9/2021 | 0 |
| 1220723 | 4/16/2021 | AL | 36 | M | 36 year old male with hx of hypertension , asthma, schizophrenia . he recieved Janssen vaccine on 4/6/2021. he started to fell unwell on 4/14 and on 4/15 he was found by his father unresponsive then sent to the hospital. Pt was diagnosed with massive pulmonary embolism, severe shock, acute renal failure ,Diabetic ketoacidosis , hyperglycemic hyperosmolar nonketotic coma, acute respiratory failure, patient expried from massive pulmonary embolism within 48 hours after admission. | 4/16/2021 | 4/6/2021 | 4/14/2021 | 8 |
| 1223714 | 4/17/2021 | MA | 36 | M | This information is second hand, I have not been in contact with next of kin- I am reporting this because I don't know if anyone else including a medical examiner or his PCP would know that he was recently vaccinated. I was told that this patient was feeling sick for a couple of weeks. A friend visited him within the last couple days and he had a migraine headache. When they went to check on him today they found him deceased in his chair. Further investigation would be needed. | 4/17/2021 | 3/20/2021 | 4/17/2021 | 28 |
| 1247816 | 4/23/2021 | NC | 36 | F | patient called EMS with pain crisis and noted that she had lost vision in both eyes. was transported to Emergency room by EMS and had cardiac arrest and died. | 4/23/2021 | 4/8/2021 | 4/23/2021 | 15 |
| 1261201 | 4/27/2021 | 36 | M | DEATH; This spontaneous report received from a patient concerned a 36 year old male. The patient's weight, height, and medical history were not reported. As per reporter patient was healthy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported, per procedure no follow up will be requested for this case. No concomitant medications were reported. The reported stated that presence of antibodies should be tested before taking the vaccine and taking the vaccine with covid antibodies present can kill. The patient died on an unspecified date with unknown cause of death after vaccination. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender's Comments: V0: 20210428954 -covid-19 vaccine ad26.cov2.s -Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH | |||||
| 1290128 | 5/5/2021 | 36 | M | Patient collapsed at home with cardiopulmonary arrest. He had been complaining of shortness of breath 1 week prior to the event, starting when he received his covid vaccination. The differential diganosis was pulmonary embolism, myocardial infarction or arrythmia. CPR was started immediately and patient received tPA during ACLS without return of spontaneous circulation. | 4/23/2021 | 4/1/2021 | 4/1/2021 | 0 | |
| 948418 | 1/15/2021 | CO | 37 | F | Expired on 1/12/2021; unknown cause of death | 1/12/2021 | 1/7/2021 | 1/12/2021 | 5 |
| 1040170 | 2/18/2021 | OR | 37 | F | Received vaccine on 2/6/2021. was a bit off all week per caregivers - low grade temp and reporting pain which they treated with Tylenol. She was pretty much herself on morning of 2/13/2021 - got up, had shower. caregivers noted her extremities were cool and face was red. temp was 97.4. She was placed in wheelchair with book in the living room. caregivers noted she was not turning pages of the book as she usually would. She was tracking, so they don't think she had a seizure. Caregiver moved her back to bed with blanket and noted that her lips were blue and at that point called 911. She was found with agonal breathing, CPR started, intubated by EMS, taken to the ER and diagnosed with cardiac arrest upon arrival. CPR was continued until family could be reached and decision was made to stop resuscitation. | 2/13/2021 | 2/6/2021 | 2/13/2021 | 7 |
| 1085413 | 3/9/2021 | CA | 37 | M | patient was on treadmill at home on 3/4/21 and became shortness of breath, collaspsed, hitting head on floor. Family started CPR, Downtime prior to ED arrival 30 minutes. Arrived at ER at 8:48AM. Intubated by EMS. initially shocked 1x but otherwise was in asystole. Eventually after about 70 minutes of CPR at ER patient had no ROSC, pupils dialted and fixed and at this point pronounced dead. | 3/4/2021 | 3/2/2021 | 3/4/2021 | 2 |
| 1085783 | 3/9/2021 | CA | 37 | M | Sudden Unexpected Death - No signs or symptoms | 3/5/2021 | 2/24/2021 | 3/5/2021 | 9 |
| 1223650 | 4/17/2021 | FL | 37 | F | In the evening on March 15th, she began having shortness of breath and chest pain. She asked her boyfriend for her blood pressure cuff so she could take her blood pressure. As he was getting it she told him to call 911 and then her eyes rolled back in her head and she stopped breathing. Paramedics attempted to revive her but were unsuccessful. She was taken to the hospital and pronounced dead. Cause of death listed as heart disease. | 3/15/2021 | 3/12/2021 | 3/15/2021 | 3 |
| 1243650 | 4/22/2021 | IL | 37 | M | Unexpected death; found unresponsive 04/20/21 morning and pronounced dead after unsuccessful resuscitative efforts | 4/20/2021 | 4/19/2021 | 4/20/2021 | 1 |
| 1270366 | 4/29/2021 | WV | 37 | M | cardiac arrest 5 days post vaccination. | 4/28/2021 | 4/19/2021 | 4/24/2021 | 5 |
| 1310174 | 5/12/2021 | TX | 37 | M | Death on 2 May 2021 | 5/4/2021 | 4/24/2021 | 5/2/2021 | 8 |
| 965256 | 1/22/2021 | GA | 38 | M | Found deceased, presumed while exercising | 1/19/2021 | 12/23/2020 | 1/19/2021 | 27 |
| 1046447 | 2/22/2021 | NM | 38 | F | 2/12/2021 Vaccine 2/13/2021 Weakness, oral ulcers 2/17/2021 Brought to ER for loss of consciousness, altered mental status, rectal bleeding; work up showed sepsis, UTI, anemia, pneumonia, pleural effusion, pancytopenia, hypotension; persistent hypotension and respiratory failure 2/18/2021 Passed away at 5:54AM | 2/18/2021 | 2/12/2021 | 2/13/2021 | 1 |
| 1145526 | 3/29/2021 | CA | 38 | F | 3/13- First shot of Moderna vaccine received. 3/14- Sore arm, chills and a headache. 3/15- Shortness of breath and rapid heartbeat. 3/16- Went to ER because of more severe shortness of breath and rapid heartbeat. 3/17- COVID test with negative result. 3/19- Patient messaged her PCP explaining persisted symptoms. 3/23- Chest pain and shortness of breath developed and she died at ER in PEA. 3/25- Autopsy showed pulmonary embolism with no evidence of peripheral vascular disease. Double check COVID test with negative result. | 3/23/2021 | 3/13/2021 | 3/14/2021 | 1 |
| 1154639 | 3/31/2021 | MI | 38 | M | Patient began having seizures about four hours post vaccine while at a friends house and passed away | 3/27/2021 | 3/27/2021 | 3/27/2021 | 0 |
| 1168104 | 4/3/2021 | VA | 38 | F | Pfizer COVID Vaccine treatment under Emergency Use Authorization(EUA): Vaccination received 3/2/2021. On 3/16/2021, maternal cardiac arrest, terminal fetal bradycardia, emergent C-section. Likely amniotic fluid embolism and DIC. | 3/18/2021 | 3/2/2021 | 3/18/2021 | 16 |
| 1186348 | 4/9/2021 | VA | 38 | F | Copied from MD discharge note - Patient is a 38 y.o. female with PMH significant for asthma and lupus not on any treatment admitted on 3/27/2021 with progressive shortness of breath and cough for months, found to have hypoxia, bilateral multifocal infiltrate without pulmonary embolism on CTA, leukocytosis, elevated troponin, elevated BNP, normal EF on echocardiogram. COVID- 19 tests were negative 4 times in the last 1 week. Blood cultures were negative. Urine and strep antigens are negative. HIV-1 also negative. Rheum consulted for hx of lupus. They did not feel this was lupus pneumonitis. Negative anti-dsDNA/SSA/SSB and RF. Pts resp status continued to decline. She was intubated on 4/3 and transferred to the ICU. Bronch washings were also neg for COVID. Despite neg cultures pt was given multiple rounds of abx including vanc, merrem, azithromycin, cefepime, without benefit. IV steroids added for possible reactive pneumonitis. Pt with shock, likely multifactorial including septic and cardiogenic. Multiple pressors maximized and BP remained low. Nephro following for worsening renal function. CRRT initiated to attempt to correct electrolyte and acidosis. Pt did not tolerate CRRT after several adjustments by neprho, pts electrolytes continued to drift from normal. Hgb dropped and CRRT held. Pt went into cardiac arrest at 1329 on 4/8/21. After several rounds of epinephrine and optimized ACLS, no pulse was recovered and ROSC was not achieved. Family notified of death at 1344 on 4/8/21 | 4/8/2021 | 3/17/2021 | 3/24/2021 | 7 |
| 1198967 | 4/12/2021 | CA | 38 | F | Cardiac arrest, death | 4/7/2021 | 3/31/2021 | 4/7/2021 | 7 |
| 1244990 | 4/22/2021 | AZ | 38 | M | After receiving the second dose of the vaccine, my husband experienced left arm pain which he thought was from the injection. About a week later, the pain got worse and moved toward his chest. It got so bad, he had to be taken by ambulance to the hospital to find out he had been having a heart attack. He spent nearly three weeks in the hospital before he died on 4/15/21 | 4/15/2021 | 3/19/2021 | 3/19/2021 | 0 |
| 1247401 | 4/23/2021 | PA | 38 | M | Patient received Moderna Vaccine on Friday 4/16/2021 12:00pm in dialysis clinic. Over the weekend family called and left a message stating that patient CTB on Friday 4/16/2021 around 8pm. | 4/16/2021 | 4/16/2021 | 4/16/2021 | 0 |
| 1264618 | 4/27/2021 | TX | 38 | M | 103 fever 2 days after the vaccine. Then became afebrile. Then found deceased on 4-26-2021 | 4/26/2021 | 4/21/2021 | 4/26/2021 | 5 |
| 1289723 | 5/5/2021 | CA | 38 | F | Death. Approximately 12 hours after administering the vaccination shot, patient experienced a medical emergency and lost her pulse. Paramedics attempted to resuscitate her for about 80 minutes. Her heart was unable to be restarted. She was declared deceased at 3:00 AM locally. | 5/4/2021 | 5/3/2021 | 5/4/2021 | 1 |
| 1297262 | 5/7/2021 | CA | 38 | M | The patient had developed a rash, fatigue, difficulty breathing, stomach pain, possible fever and began to cough up blood. He took Tylenol and a Chinese herbal medication called Lianhua Qingwen Jiaonang on 5/5/21. It is unclear when his symptoms began, as he did not share that information with his wife until 5/5/21. | 5/7/2021 | 5/3/2021 | 5/5/2021 | 2 |
| 921667 | 1/5/2021 | OH | 39 | F | LTCF Pfizer Vaccine clinic conducted 12/29/2020 Vaccine lead received a call indicating that a staff member deceased somewhere between 1/3/2021 and 1/4/2021. Cause of death is unknown, and an autopsy is being performed. | 1/3/2021 | 12/29/2020 | 1/3/2021 | 5 |
| 1037207 | 2/17/2021 | UT | 39 | F | She had pain in the injection site Tuesday night and then during Tuesday she got worse with nausea and some fever. By Wednesday she was complaining that she could not pee even though she was drinking a lot of fluids. She continued to complain it was the worst she ever felt and then at 0600 Thursday morning she woke us up and said she needed to go to the hospital. We arrived at the hospital just before 0700 and she immediately threw up in the trash can. We went into a treatment room and they took blood and started fluids as she became incoherent. She said she had taken Tylenol so they started a drug to counter that but her liver function was all wrong and they started to look for a hospital that could transplant a liver. She was air evade about 0930 to Medical center and just over 30 hours latter she was dead. There is a pending autopsy. She was a healthy 39 year old mother who got the shots because she worked as a surgical tech and she was the single mother of a 9 year old little girl. | 2/5/2021 | 2/1/2021 | 2/2/2021 | 1 |
| 1095327 | 3/12/2021 | ID | 39 | F | I was alerted on 3.11.21 by the patient's wife that patient had passed away the night after having received the vaccine. The wife informed me that she did not wake up the next morning. | 2/23/2021 | 2/23/2021 | 2/23/2021 | 0 |
| 1104671 | 3/16/2021 | MI | 39 | M | Patient has a long history of seizures. He has seizures on a daily basis. He lives with his family, who are his primary caregivers, they family provides all of his activities of daily living. Patient received vaccine on Friday morning, feeling well throughout the day according to the father. Went to bed, during the night in bed he had seizures which is typical for him, and during the episode the father noticed that he had stopped breathing. called 911 who came to the house and the patient died in the house. I do not believe he went to the hospital. | 3/13/2021 | 3/12/2021 | 3/13/2021 | 1 |
| 1116808 | 3/19/2021 | 39 | F | No symptoms reported. Found dead seated on couch the day after vaccination (3/14/2021). Autopsy performed on 3/15/2021 showed no evidence of anaphylaxis. Cause of death = Cardiomyopathy of Obesity. | 3/13/2021 | 3/13/2021 | 3/13/2021 | 0 | |
| 1121847 | 3/22/2021 | NY | 39 | F | Kidneys and liver shutting down; Kidneys and liver shutting down; Heart started racing 3 days later; Vomiting; A spontaneous report was received from a consumer concerning a 39-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced heart racing, kidney failure, liver failure,vomiting and death. The patient's medical history included Sjogren's syndrome, Hashimoto's, inflammatory joint disease, osteoporosis, osteoarthritis. She has history of fractured tail bone and leg in three places. Concomitant medications included D3 2 pills a day, folic acid, B12, and calcium citrate. She was allergic to 15 different antibiotics two of which she had anaphylaxis; had huge autoimmune issues; had had reaction to Pneumovax vaccine. On an unown date ,prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. Approximately after three days of receiving second dose vaccine patient experienced heart racing and went to the emergency room .The patient started vomiting and developed a kidney and liver failure. And on the next day she died.Autopsy is doing and the results are not available at the time of report. Action taken with mRNA-1273 in response to the events was reported as not applicable. The events heart racing, kidney failure, liver failure and death were considered serious and medically significant. The outcome of the events renal failure,hepatic failure,palpitations and vomiting was considered as Fatal.; Reporter's Comments: This is a case of death in a 39year-old female subject with unknown medical history of anaphylactic reactions, allergic reactions to pneumovax vaccine, Sjogren's syndrome, Hashimoto's, inflammatory joint disease, osteoporosis, osteoarthritis, who died 4 days after receiving second dose of vaccine. Very limited information has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Renal failure; Hepatic failure | ||||
| 1144826 | 3/29/2021 | 39 | M | received word that the patient passed away on 3/5/2021. Do not know the cause of death, nor where he passed away. He does not have any significant medical history at Health Care Corporation, but did get his first vaccination here on 2/17/2021. | 3/5/2021 | 2/17/2021 | 3/5/2021 | 16 | |
| 1201543 | 4/13/2021 | NC | 39 | F | Death | 4/6/2021 | 3/3/2021 | 3/12/2021 | 9 |
| 1216091 | 4/15/2021 | AZ | 39 | M | Patient at gym working out and had a seizure, when 9-1-1 crews arrived patient was post-ictal, while treating the patient he had another seizure, during transport patient went into cardiac arrest, crews provided ACLS care and transported patient to hospital for treatment. Resuscitation efforts were terminated by physician in emergency room. | 4/13/2021 | 3/23/2021 | 4/13/2021 | 21 |
| 1221166 | 4/16/2021 | IN | 39 | F | needed kidney and/or bladder transplant; within 30 hs after second shot, she died; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DEATH (within 30 hs after second shot, she died) and TRANSPLANT (needed kidney and/or bladder transplant) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DEATH (within 30 hs after second shot, she died) (seriousness criterion death) and TRANSPLANT (needed kidney and/or bladder transplant) (seriousness criteria death, hospitalization and medically significant). The cause of death was not reported. It is unknown if an autopsy was performed. The reporter does not remember if this was from Pfizer or Moderna. Concomitant product us e was not provided. Treatment information was unknown. This case concerns death of a 30 year old female 30 minutes after the administration of the mRNA-1273 vaccine. Patient is reported to have no underlying issue. Based on the current available information which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, causal relationship cannot be excluded. Reporter did not allow further contact; Reporter's Comments: Th; Sender's Comments: This case concerns death of a 30 year old female 30 minutes after the administration of the mRNA-1273 vaccine. Patient is reported to have no underlying issue. Based on the current available information which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, causal relationship cannot be excluded.; Reported Cause(s) of Death: unknown cause of death | ||||
| 1246534 | 4/23/2021 | NY | 39 | F | Patient felt initially well, but later in that afternoon her arm started hurting and she felt increasingly nauseous and started vomiting at 10:49pm, two hours later she was pronounced dead at approximately 12:30am. | 4/10/2021 | 4/9/2021 | 4/9/2021 | 0 |
| 1257204 | 4/25/2021 | MO | 39 | F | Patient began experiencing pain and difficulty walking on Tuesday, March 23. Later that afternoon she was taken to an Urgent care, who sent her to the ER for evaluation. She was diagnosed with a very large blood clot in her leg, spanning from just above the knee to her groin area. They admitted her and began treating her with blood thinners. While undergoing that treatment, her heart stopped 3 times and she had to be resuscitated. They discovered a pulmonary embolism. While removing a large clot from her lungs, the doctor found that her lungs were riddled with hundreds of tiny blood clots. They also said that she was bleeding internally, very heavily, from an unknown location. In all, they gave her 20 units of blood, and none of it stayed in her veins. The doctor said it seemed to just disintegrate. At that point, her brain and organs had begun shutting down and family made the decision to remove her from life support. She passed away Thursday evening, March 25, 2021. | 3/25/2021 | 3/3/2021 | 3/23/2021 | 20 |
| 982826 | 1/28/2021 | NV | 40 | M | Was at work on 1/26/21 and collapsed, no known complaints a the time. CRP was initiated immediately, transported to ER and pronounced dead | 1/26/2021 | 1/21/2021 | 1/26/2021 | 5 |
| 1000228 | 2/4/2021 | NV | 40 | M | dead; Collapsed; bnt162b2 was given to patient with immunocompromised w/ reportable conditions; bnt162b2 was given to patient with immunocompromised w/ reportable conditions; This is a spontaneous report from a contactable nurse. A 40-year-old male patient receive first dose of bnt162b2 (Lot number: EK9231, Brand: Pfizer), intramuscular in left arm on 21Jan2021 15:15 at single dose for COVID-19 immunization. Medical history included immunocompromised w/ reportable conditions from an unknown date and unknown if ongoing, positive for Covid in September from Sep2020 to an unknown date. The patient's concomitant medications were not reported. The patient experienced dead, collapsed on 26Jan2021. Therapeutic measures were taken as a result of collapsed. The outcome of collapsed was unknown. The patient died on 26Jan2021. It was not reported if an autopsy was performed. Received Covid vaccine here on 21Jan2021, was at work on 26Jan2021 and collapsed, no known complaints at the time, CPR (cardiopulmonary resuscitation) was initiated immediately, transported to ER (Emergency room) and pronounced dead. Unknown if other vaccine in four weeks. The patient had COVID prior vaccination. Unknown If COVID tested post vaccination.; Sender's Comments: Based on the information currently provided, the patient was immunocompromised and had prior COVID infection. The death and syncope more likely are associated with the patient underlying medical conditions. More information such medical history, concomitant medications, treatment indication and event term details especially death cause and autopsy results are needed for fully medical assessment. 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 Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Dead | 1/26/2021 | 1/21/2021 | 1/21/2021 | 0 |
| 1174338 | 4/7/2021 | VA | 40 | M | Patient died 12-15hrs after vaccination.; This is a spontaneous report from a contactable Consumer. A 40-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Right on 25Mar2021 12:45 (Batch/Lot Number: ER8727) at the age of 40-year-old as single dose for covid-19 immunisation. Medical history reported as none. Concomitant medication included buprenorphine hydrochloride, naloxone hydrochloride (SUBOXONE) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient patient died 12-15 hours after vaccination. The patient died on 26Mar2021. An autopsy was not performed. No treatment received for the event. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was not been tested for COVID-19.; Reported Cause(s) of Death: Patient died 12-15hrs after vaccination. | 3/26/2021 | 3/25/2021 | 3/26/2021 | 1 |
| 1235191 | 4/20/2021 | KS | 40 | F | my sister had a ruptured brain aneurysm on 3/25/2021 | 3/29/2021 | 2/11/2021 | 3/25/2021 | 42 |
| 1248086 | 4/23/2021 | CO | 40 | M | Moderna COVID-19 Vaccine EUA: patient underwent L1-2 corpectomy, pedicle subtraction osteotomy, and extension of fusion from T4 to the pelvis two months after vaccination. During surgery patient became thrombocytopenic and required massive transfusion. Thirteen days after surgery found to have bilateral pulmonary embolisms and deep vein thromboses and placed on anticoagulation. Patient subsequently suffered cardiac arrest and was unable to be resuscitated. | 4/20/2021 | 2/5/2021 | 4/6/2021 | 60 |
| 1266821 | 4/28/2021 | MD | 40 | F | Pt was seen in Family Medicine on 4/23/2021. Was given her first Moderna vaccine that day. On-call doctor received phone call on 4/24/2021 that pt had expired. Death certificate states cause of death: seizure due to possible complication of COVID 19 vaccine. Conditions if any, leading to immediate cause: cerebellopontine angle tumor of brain | 4/24/2021 | 4/23/2021 | 4/24/2021 | 1 |
| 1276530 | 5/1/2021 | OR | 40 | F | DEATH; BLOOD CLOT; This spontaneous report received from a consumer news/social media platform concerned a 5 decade old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the patient developed a rare blood clot and died within two weeks of getting the Janssen covid vaccine. On an unspecified date, the patient died from unknown cause of death. It was unknown whether autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blood clot was not reported. This report was serious (Death, and Other Medically Important Condition). This case, from the same reporter is linked to.; Sender's Comments: V0-covid-19 vaccine ad26.cov2.s-This case concerns with 5 decade old female. Death, Blood clot. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH | ||||
| 1279801 | 5/2/2021 | OH | 40 | F | Death. Autopsy was done. Awaiting results | 4/22/2021 | 3/22/2021 | 4/22/2021 | 31 |
| 1306318 | 5/11/2021 | MD | 40 | F | Went back to sleep and never woke up; Arm soreness; Feeling bad; very flushed/looked red; very tired/fatigue/nappy women taking a lot of naps; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Went back to sleep and never woke up) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C2117) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Neurofibromatosis, type 2 (acoustic neurofibromatosis) (Diagnosed at age 11, had tumor on nerves and all over body.), Blindness (All blind in left eye), Allergy NOS (unspecified allergy), Walker user and Feeding tube user. On 23-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced DEATH (Went back to sleep and never woke up) (seriousness criterion death), PAIN IN EXTREMITY (Arm soreness), VACCINATION COMPLICATION (Feeling bad), FLUSHING (very flushed/looked red) and FATIGUE (very tired/fatigue/nappy women taking a lot of naps). The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, PAIN IN EXTREMITY (Arm soreness), VACCINATION COMPLICATION (Feeling bad), FLUSHING (very flushed/looked red) and FATIGUE (very tired/fatigue/nappy women taking a lot of naps) outcome was unknown. The patient was on a feeding tube, lived independently but had a caretaker who came in every day. The patient had long list of medications for her conditions but concomitant medications were not provided by the reporter. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not applicable. Regarding the events of Pain in extremity, Fatigue, Flushing, Vaccination related malaise, based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, regarding the event of Death,Very limited information regarding this event has been provided at this time. Further information has been requested.; Sender's Comments: Regarding the events of Pain in extremity, Fatigue, Flushing, Vaccination related malaise, based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, regarding the event of Death,Very limited information regarding this event has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death | 4/23/2021 | 4/23/2021 | 4/23/2021 | 0 |
| 1308207 | 5/11/2021 | TX | 40 | M | #2 Moderna Vaccine given on 4/20/21 On 5/7/21 patient became SOB before syncope to cardiac arrest, event was witnessed and CPR started immediately. Patient expired 45 min later at Medical Center. | 5/7/2021 | 4/20/2021 | 5/7/2021 | 17 |
| 1027619 | 2/13/2021 | PA | 41 | M | Swollen leg/pain- taken to urgent care- became unresponsive - CPR initiated- expired | 2/11/2021 | 2/10/2021 | 2/11/2021 | 1 |
| 1055070 | 2/25/2021 | OR | 41 | F | Client died on 02/21/2021 and had received the second dose of the vaccine series on 02/19/2021. | 2/21/2021 | 2/19/2021 | 2/21/2021 | 2 |
| 1180895 | 4/8/2021 | 41 | F | death Narrative: Pt with hx substance use disorder (on suboxone), depression, PTSD, SI and grief following her son's suicide. Pt received COVID vaccine 3/14/21. Clinic notified of pt's death on 4/6, for which it HAS NOT BEEN VERIFIED but reported death date of 4/3. Pt was scheduled for MH f/u appt 4/5, but no-showed it. Unclear report or cause of death, however, suspected via suicide or drug overdose given risk factors and worsening of mental illnesses. Was pt previously covid positive? No Are there any predisposing factors (i.e. PMH, HPI, allergy history etc) for patient experiencing adverse drug event? No Any occurrence of an ADR at time of administration or during time of observation? No Did patient recover from event? N/A - pt died but does not appear related to vaccine Was there an ADR between observation period and date of death? No Was patient hospitalized prior to vaccination? No Was patient hospitalized between vaccination and date of death? No Was patient hospitalized prior to death No What are the possible cause of death? Suicide, illicit drug overdose | 4/3/2021 | 3/14/2021 | 4/3/2021 | 20 | |
| 1259763 | 4/26/2021 | MI | 41 | M | Fever, chills, headache, and tiredness (2nd day of receiving the 2nd dose) Feeling good on the 3rd day Headache, stomach burn, throwing up, and heart attack (4th day of receiving the 2nd dose) Passed away on April 2, 2021 | 4/2/2021 | 3/29/2021 | 4/2/2021 | 4 |
| 1267794 | 4/28/2021 | AK | 41 | M | Approximately 3 weeks after Moderna Covid-19 vaccine administration, patient began to experience dizziness, transferred to Hospital, diagnosed with ischemic stroke, discharged, returned within days with worsening, diagnosed with new ischemic stroke (contralateral side), transferred to Medical Center, patient's condition worsened, presumably additional new ischemic stroke, patient ultimately died on 3/5/2021. Diagnosis was acute infarction of the brainstem/pons as well as acute bilateral cerebellar/occipital infarctions. | 3/5/2021 | 2/5/2021 | 2/24/2021 | 19 |
| 1295555 | 5/7/2021 | MN | 41 | M | Patient found dead | 5/1/2021 | 4/30/2021 | 5/1/2021 | 1 |
| 992237 | 2/1/2021 | MO | 42 | M | 1/28/2021- Seen by FNP for indigestion, chest pressure and palpitations. EKG reviewed and referral made to Cardiology. 1/29/2021-1800 Presented to ED in cardiac arrest-onset PTA. Patient was found unresponsive by his wife at their home. The last known well was at 1530 when she called him on the phone. The patient was pronounced at ~1850. | 1/29/2021 | 1/25/2021 | 1/29/2021 | 4 |
| 1035597 | 2/17/2021 | GA | 42 | M | Death on 1/17/2021. Found at home deceased. | 1/17/2021 | 12/30/2020 | 1/17/2021 | 18 |
| 1202257 | 4/13/2021 | UT | 42 | F | Brother called pharmacy on 04.13.2021 at approximately 10am and informed pharmacist that his sister had passed away due to a pulmonary embolism about 2 weeks after receiving her first dose of the Moderna COVID vaccination at our pharmacy. He mentioned that healthcare provider was looking at possible gene mutation in family that may have contributed. | 3/24/2021 | 3/5/2021 | 3/19/2021 | 14 |
| 1214500 | 4/15/2021 | WA | 42 | F | Patient at 27 weeks of pregnancy, reported to midwife at regular visit on 4/14/21 that she was experiencing SOB but all blood work normal - assumed normal SOB with pregnancy. Night/morning of 4/15 started seizures, transported to ED. Diagnosed with massive pulmonary embolism. Emergency C-section prerformed by Dr. Pt. did not survive. | 4/15/2021 | 4/2/2021 | 4/14/2021 | 12 |
| 1277679 | 5/1/2021 | MI | 42 | M | Death on 04/30/2021 | 4/30/2021 | 4/9/2021 | 4/30/2021 | 21 |
| 1301355 | 5/9/2021 | KY | 42 | F | She began having shortness of breath after getting her second shot. He parents found her dead in her bed this afternoon. No other known comorbidities. | 5/9/2021 | 5/6/2021 | 5/6/2021 | 0 |
| 1304956 | 5/11/2021 | 42 | M | BLOOD CLOT; This spontaneous report received from a company representative concerned a 42 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number and expiry were unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, between three to ten days later after vaccination the patient died due to blood clots. It was unknown, whether autopsy was performed or not. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender's Comments: V0;20210510772-covid-19 vaccine ad26.cov2.s-Thrombosis. This event(s) is considered unassessable. The event(s) has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: BLOOD CLOT | |||||
| 933578 | 1/11/2021 | NY | 43 | M | Pronounced dead 1/9/2021 at 12:42. Received first dose of vaccine 1/8/2021 | 1/8/2021 | |||
| 1073092 | 3/4/2021 | IL | 43 | M | The decedent reported a continuous headache since receiving the vaccination. On March 3rd he suffered a cardiac arrest and was pronounced deceased. | 3/3/2021 | 2/11/2021 | 3/3/2021 | 20 |
| 1112122 | 3/18/2021 | CA | 43 | M | Patient was admitted for Multi drug resistant UTI (for which he has been admitted many times before). Was hospitalized for 3 days while awaiting cultures, hemodynamically stable, with no lab abnormalities. On the day of discharge (sensitivities to UTI came back, pt to be discharged on cefepime, had PICC line) pt got up from bed, sat on the edge of the bed and was being given belongings by the nurse, alert and oriented and in a pleasant mood, when suddenly pt grabbed at his chest and stated "I can't breathe" and became combative and altered when O2 was attempted to be placed on pt's face; then pt had PEA arrest x3 and unable to achieve ROSC. | 3/15/2021 | 3/13/2021 | 3/15/2021 | 2 |
| 1171191 | 4/6/2021 | KS | 43 | M | Patient was found dead in his apartment. I'm not clear on details, but he was having some issues the week prior to being vaccinated. He was in acute distress when his attendant care worker came to give him his medications the day before. | 4/1/2021 | 3/31/2021 | 4/2/2021 | 2 |
| 1251028 | 4/24/2021 | LA | 43 | M | Death by suicide sometime between late evening Wednesday, April 21st, 2021 and early morning April 22nd, 2021. He was found at about 8am that morning. | 4/22/2021 | 4/14/2021 | 4/22/2021 | 8 |
| 1313803 | 5/13/2021 | CA | 43 | M | Received vaccine on 5-6-21. On 5-8-21, complained of headache, bloating, fever, and constipation. Last seen alive at 9 PM on 5-8. Found dead at home at 7 PM on 5-9. | 5/9/2021 | 5/6/2021 | 5/8/2021 | 2 |
| 1314069 | 5/13/2021 | OH | 43 | F | DEATH | 5/13/2021 | 5/12/2021 | 5/13/2021 | 1 |
| 937527 | 1/12/2021 | NH | 44 | F | unsure if related to vaccine, but was notified by her next of kin that she died on 1/4/2021. No reports of side effects or hospitalization were reported to the facility prior to the notification of death. | 1/4/2021 | 12/23/2020 | 1/4/2021 | 12 |
| 1072113 | 3/4/2021 | 44 | M | Death | 2/16/2021 | 2/12/2021 | 2/14/2021 | 2 | |
| 1079976 | 3/7/2021 | NY | 44 | M | 12/23/20 (Moderna #1) - Malaise, cough on 12/24, went to walk-in on 12/25 c/o cough, malaise, rx'd Augmentin x14d, Rapid covid negative (and PCR resulted negative). 12/27 slept all day, 12/28 back to work. 1/12/21 metallic taste in mouth, severe GI sx, malaise, aches, headache. 1/14 seen at walk-in and covid swabbed Negative. 1/21/21 exposed to parents who found out they were covid + on 1/22/21. 1/25/21 (Moderna #2) - Continued with persistent cough and GI sx. Then also developed urinary frequency and urgency. Seen at urgent care 2/1 c/o cough, dx URI, rx'd augmenting. Woke up morning of 2/2/21 abruptly, stood up, said something was wrong, and collapsed. CPR attempted immediately, EMS brought him to ER where he was pronounced dead. | 2/2/2021 | 12/23/2020 | 12/23/2020 | 0 |
| 1145054 | 3/29/2021 | 44 | F | patient received 2nd dose of Moderna on 3/13/2021; reported by Police Department as having passed away on 3/14/2021. No other details available. | 3/14/2021 | 3/13/2021 | 3/14/2021 | 1 | |
| 1171601 | 4/6/2021 | NC | 44 | M | Loss of appetite, malaise, nausea, falls, mental fog, death. | 4/2/2021 | 3/19/2021 | 3/20/2021 | 1 |
| 1178887 | 4/7/2021 | MD | 44 | U | Death | 4/7/2021 | 4/6/2021 | 4/7/2021 | 1 |
| 1189015 | 4/10/2021 | ME | 44 | M | Patient was given the vaccine without incident at or near 0924a. He previously was diagnosed, through PCR test to have COVID-19 back in December 2019. Outside of supportive therapy at home, he was not treated and was not hospitalized and he recovered within a few weeks. At or near 930-10p, on April 9th, approximately 12 hours after the vaccine was given, while out at a restaurant with family, the patient experienced a medical event, (what appears to be an acute coronary event) and died. | 4/9/2021 | 4/9/2021 | 4/9/2021 | 0 |
| 1205423 | 4/13/2021 | CO | 44 | M | Patient's physician reported this adverse event by phone to Medical Center administration on 4/13/2021. Per the physician, the patient received his 2nd Pfizer COVID19 vaccination dose on Friday 4/9/2021 at the drive through vaccination clinic. On Saturday 4/10/2021 the patient told to his wife that he felt ill, continuing through Sunday. On Sunday, 4/11/2021, at his home, the patient told his wife that he felt ill and went to sleep. The patients wife found him not breathing, called 911 and started CPR. The patient was pronounced deceased at his home and was not transported to hospital. | 4/11/2021 | 4/9/2021 | 4/10/2021 | 1 |
| 1236415 | 4/16/2021 | 44 | M | death Narrative: Patient received Moderna covid vaccine #1 on 3/25/21. No notes entered after this time and date of death is recorded as 3/30/21. No scanned records. No autopsy results available. 5 days from date of vaccine to date of death. | 3/30/2021 | 3/25/2021 | 3/30/2021 | 5 | |
| 1230371 | 4/19/2021 | IL | 44 | M | Patient passed away on 4/13 after presenting to local hospital with near syncope and AKI. Records from local hospital are unavailable, unclear regarding cause of death and circumstances thereforth. | 4/13/2021 | 4/10/2021 | 4/13/2021 | 3 |
| 1242906 | 4/22/2021 | OH | 44 | M | Pharmacy was contacted by an aunt, who is also a healthcare provider. This contact was requested by the family. Per nurse practitionar who is the aunt of the deceased), patient passed away on Monday, 4/19/2021. He was found unresponsive on a jogging trail, where he had been jogging, by a third party person. They had called an ambulance and could not revive him. Family requested a VAERS report due to the proximity in time to his 2nd Pfizer vaccination. He had received his vaccination at 9:56am on 4/14/21 (lot ER8730) and per father the only side effect he indicated was a sore arm. Autopsy pending per family. | 4/19/2021 | 4/14/2021 | 4/19/2021 | 5 |
| 929764 | 1/8/2021 | WA | 45 | M | The patient was found deceased at home about 24 hours after immunization. Date of Death:: 12/29/2020; estimated time of death 6:00pm | 12/29/2020 | 12/28/2020 | 12/29/2020 | 1 |
| 961339 | 1/21/2021 | GA | 45 | F | possibly got it at clinic, possibly who administered shot. Pts. daughter said the pts boyfriend denied any symptoms the whole day but that in the middle of the night the pt passed away. | 1/19/2021 | 1/18/2021 | 1/19/2021 | 1 |
| 1006640 | 2/5/2021 | NM | 45 | F | In discussion with Dr., medical director at Detox, she arrived night of 2/3/21 was quite intoxicated so was not going through any withdrawal. She was getting vitals and CIW checked regularly. First dose of chlordiazepoxide 25mg was 2/4 at 1:25pm for CIWA 9. She had repeat vitals at 5:50pm, CIWA 1, vitals: P 67, 118/79, 94% on RA, T 98.3. she had complained of some "pressure in her head" and feeling anxious, but otherwise denied other complaints. she was talking with others in the group, then other patients report she suddenly started having seizure like activity around 6:45pm, med techs came to help and found her stiff, gurgling. they tried to get vitals on her, called 911, noticed that at 6:54pm she had lost a pulse and they started CPR. paramedics arrived at 7:08pm and she was brought to ED. Pt BIBA in cardiac arrest. Pt was at Detox Center when she was reported to have seizure-like activity followed by collapse. She was found to be pulseless and CPR initiated by staff members. EMS arrived and performed approx 15 min of CPR and gave pt epi x 3 and bicarb. No shocks administered but they did not report a rhythm. In the emergency room the patient arrived and was found to be pulseless with PEA arrest, CPR was initiated, patient was intubated. ROSC ultimately achieved, patient remained very acidotic despite ventilator adjustment, head CT revealed cerebral edema. Pt also found to be profoundly anemic with a hemoglobin of 5 and platelets of 37, she was thought to be GI bleeding so medications for this were initiated. Patient then became more hypoxemic with bradycardia, consultation with neurosurgery and critical care medicine at tertiary care center deemed ongoing CPR futile. Patient arrested at 2:30AM on 2/5, pronounced dead at 2:48AM. | 2/5/2021 | 2/3/2021 | 2/4/2021 | 1 |
| 1020702 | 2/10/2021 | VA | 45 | F | Passed away the morning of 2/9/21. | 2/9/2021 | 1/20/2021 | 2/9/2021 | 20 |
| 1061911 | 3/1/2021 | OH | 45 | F | Died at home; Gasping for air/difficulty breathing; Soreness; A spontaneous report was received from a physician concerning a 45 years-old, female patient who experienced soreness/MedDRA PT: pain, gasping for air/difficulty breathing/MedDRA PT: dyspnoea and subsequently died/MedDRA PT: death. The patient's medical history included blood pressure (disorder not specified), thyroid disorder, depression and anxiety. Concomitant product use included blood pressure medication, thyroid medication and possibly depression and anxiety medication. On 28 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot #007M20A) (route of administration and injection site not provided) for prophylaxis of COVID-19 infection. On 28 Jan 2021, following the vaccination, the patient was fine but had experienced some soreness. Per patient's coworker, the patient did not take any medication as it made the patient sick. The physician was not aware of any complaints from the vaccine. On 13 Feb 2021 at 3:31am, the patient called 911. Per the 911 call, the patient was gasping for air on the call and having difficulty breathing. The patient subsequently died on 13 Feb 2021 at home. The physician inquired whether Moderna gets involved with the autopsy and logistics of the death of patients and wanted to know the time frame for reporting a death of a patient who received the vaccine. The physician did not know who administered the patient's vaccine. Action taken with mRNA-1273 in response to the events was not applicable as the patient deceased. The event died was fatal. The outcome for the events soreness and gasping for air/difficulty breathing was unknown. The patient died on 13 Feb 2021. The cause of death was not provided. Plans for an autopsy were not provided.; Reporter's Comments: Very limited information regarding the event of dyspnea and death has been provided at this time. Further information has been requested. Patient's medical history of blood pressure is considered a risk factor. Based on the current available information and temporal association between the use of the product and the onset of the pain, a causal relationship cannot be excluded.; Reported Cause(s) of Death: Died at home | 2/13/2021 | 1/28/2021 | 1/28/2021 | 0 |
| 1093986 | 3/12/2021 | LA | 45 | F | Received a phone call stating that the patient complained of not feeling well on 3/11/21 while at work and that the patient died that night while at home. | 3/11/2021 | 3/10/2021 | 3/11/2021 | 1 |
| 1114806 | 3/19/2021 | VA | 45 | F | Diagnosis: Cortical vein thrombosis, massive intracerebral hemorrhage with tentorial herniation, thrombocytopenia. Clinical Presentation and Course: 1 week after receiving Janssen COVID19 vaccination, patient developed gradually worsening headache. On March 17th, patient presented to Hospital with dry heaving, sudden worsening of headache and L sided weakness. Evaluation with head CT revealed a large R temporoparietal intraparenchymal hemorrhage with 1.3cm midline shift. She ended up getting intubated for worsening mental status. On evaluation at arrival in Medical Center, she was noted to have extensor posturing. Repeat imaging revealed worsening midline shift to 1.6cm. CTA showed cortical vein thrombosis involving the right transverse and sigmoid sigmoid sinus with tentorial herniation. Patient developed brain herniation and brain death was pronounced on March 18th, 2021. | 3/18/2021 | 3/6/2021 | 3/12/2021 | 6 |
| 1156266 | 4/1/2021 | 45 | F | pt presented in ER 3/17/21 with SOB and back pain; felt bad since vaccine given; UTI diagnosis-given keflex 500 tid and rocephin shot pt presented to clinic 3/19/21 with continuing back pain dx low back pain and candidia given methocarbamol, diflucan, and ibuprofen pt presented to clinic 3/26/21 with continuing back pain, difficulty urination. given ceftin and rocephin shot pt presented to ER 3/27/21 renal failure and expired within 10 min of arrival no fever documented at any visit | 3/27/2021 | 3/4/2021 | 3/17/2021 | 13 | |
| 1175952 | 4/7/2021 | MN | 45 | M | Patient death within 60 days of receiving the COVID vaccine series | 3/25/2021 | 2/4/2021 | 3/25/2021 | 49 |
| 1186471 | 4/9/2021 | PA | 45 | M | Complaints of diarrhea, sweating, weakness suffered sudden cardiac arrest. CPR, AED, Lucas device applied ACLS protocol initiated by EMS. Efforts terminated. Patient pronounced deceased at 1003am. | 4/9/2021 | 4/7/2021 | 4/9/2021 | 2 |
| 1198162 | 4/12/2021 | MO | 45 | F | My sister received the Janssen vaccine on March 13, 2021. One week later, March 20, 2021, she started complaining of severe headaches, dizziness and vomiting. This continued so she visited the ER on Wednesday, March 24, 2021, where she suffered a cerebral venous sinus thrombosis. She was pronounced brain dead on March 27, 2021, which is also the same day she was pronounced dead. | 3/27/2021 | 3/13/2021 | 3/20/2021 | 7 |
| 1241805 | 4/22/2021 | AZ | 45 | M | Patient experienced a headache within 4 hours of vaccination. Took recommended dose of Tylenol. 4 hours after that (8 hours after vaccination) he was still experiencing extreme headache and also vomiting and took another dose of Tylenol. Was still feeling poor at 1am but coherent and talking, not thinking that it was serious enough to warrant going to hospital, as he believed it was just a bad headache and the vomiting was from the headache. At 6am, he was found blue/dead in his bed. | 4/18/2021 | 4/17/2021 | 4/17/2021 | 0 |
| 1274722 | 4/30/2021 | 45 | M | Pt presented to the hospital after a cardiac arrest. Work up showed renal artery thrombosis b/l causing renal failure and hyperkalemia. ROSC was achieved and pt coded multiple times after. We were unable to obtain CT A 2/2 to pt being unstable so only U/S imaging with doppler was used for diagnosis. Pt was treated with heparin gtt., hematology work up was sent but cause not identified. ECHO did not show thrombosis in the heart. CCRT was attempted but pt expired. | 4/30/2021 | 4/20/2021 | 4/28/2021 | 8 | |
| 1276773 | 5/1/2021 | MN | 45 | F | Stroke; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CEREBROVASCULAR ACCIDENT (Stroke) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Apr-2021, the patient experienced CEREBROVASCULAR ACCIDENT (Stroke) (seriousness criterion death). The patient died on 05-Apr-2021. The reported cause of death was Stroke. It is unknown if an autopsy was performed. Concomitant medications were not reported. The patient was not hospitalized prior to or during the stroke. The reporter mentioned that the organs were donated as the patient was on a ventilator.; Reported Cause(s) of Death: Stroke | 4/5/2021 | 4/5/2021 | ||
| 1278349 | 5/1/2021 | NY | 45 | M | Patient suffered a seizure and pulmonary edema four days after receiving second Pfizer shot. He was pronounced dead several hours later. Patient had no health issues and was 45 years old. | 4/29/2021 | 4/24/2021 | 4/29/2021 | 5 |
| 977319 | 1/27/2021 | MI | 46 | M | 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. | 1/25/2021 | 12/29/2020 | 1/25/2021 | 27 |
| 1028778 | 2/14/2021 | CA | 46 | M | On December 17, 2020, my husband, received his first BioNTech BNT162b2 COVID-19 vaccination. On Thursday January 7, 2021, he received this second COVID-19 vaccination. The following three days after his second vaccination, he felt fine. The fourth day, on Sunday January 10, my husband felt extremely fatigued. On Monday the 11th and Tuesday the 12th, he worked a full shift but complained of extreme fatigue and extreme chills to the point that his teeth were chattering while on the phone with me. He decided to work through it. When he got home on Monday night, he started vomiting. On Wednesday January 13, he woke up and had swollen eyes. Once again, he felt extremely fatigued, even after a full nights rest. He had the day off but had an early meeting. After his meeting, he was still tired so he went back to sleep. I left to get lunch, and drop off our kids, and upon my return, I found him on the walk in closet floor, face up, having passed away. He felt as cold as ice. The rapid test done after they called the paramedics resulted in a negative COVID-19 test for him. | 1/13/2021 | 1/7/2021 | 1/10/2021 | 3 |
| 1066118 | 3/2/2021 | PA | 46 | M | Patient had an unwitnessed cardiac arrest while outside walking his dog. AED in the field initially advised shock and was shocked 3 times without effect. At the time EMS ALS arrived, patient was in PEA arrest. He was transferred to Hospital with CPR in progress. Time of death called at 1857. | 2/17/2021 | 2/16/2021 | 2/17/2021 | 1 |
| 1066274 | 3/2/2021 | PA | 46 | F | death | 1/23/2021 | 1/21/2021 | 1/23/2021 | 2 |
| 1112164 | 3/18/2021 | MN | 46 | M | lndividual Suddenly passed away on 3/7/21.....His Psychiartrist stated that there could be an adverse effect with COVID, the COVID Vaccination and medications, with an emphasis on Clozapine | 3/7/2021 | 3/4/2021 | 3/6/2021 | 2 |
| 1122080 | 3/22/2021 | PA | 46 | F | Patient's received 2nd dose of Moderna vaccine Friday 3/12. Her husband reported she had not unexpected fatigue, malaise, and fever for 1 day but better after that. On Monday she began complaining of shortness of breath. This progressively worsened and she started having presyncopal episodes. On Saturday she was unable to come down the stairs in the house so husband planned to take her to the hospital but she stood up and passed out and woke up quickly. He decided to call EMS. By the time she presented to our hospital she was cyanotic and agonal breathing. On moving her from EMS stretcher to ED bed she had PEA cardiac arrest. She underwent mechanical device CPR with only brief (<1 min) ROSC x1. She at some point did have a shockable rhythm. Cath lab was notified and she was taken emergently to the cath lab with ongoing mechanical device CPR. Peripheral VA ECMO was placed after about 1.5 hours. Pulmonary angiogram was done which showed massive saddle PE with near complete obliteration of the right pulmonary tree and some filling defects in the left tree as well. At that time she had severe mixed respiratory and metabolic acidosis with a lactate of 24. She also had no gag or corneal reflex, minimally responsive pupils, and no response to noxious stimuli. Mechanical thrombectomy was attempted with some result. She was transferred to the SICU with increasing pressor requirement, and DIC. Ultimately, the venous catheter of the ECMO circuit malfunctioned thought to be secondary propagating IVC thrombosis. Family decided to withdraw care and she passed away. | 3/21/2021 | 3/12/2021 | 3/19/2021 | 7 |
| 1165154 | 4/3/2021 | OH | 46 | M | My husband died 18 days after the shot | 3/30/2021 | 3/12/2021 | 3/30/2021 | 18 |
| 1169650 | 4/5/2021 | TN | 46 | M | DIFFICULTY BREATHING, SEVERE CHEST PAIN, STOMACH ACHE, HEADACHE, JOINT PAIN WENT TO EMERGENCY ROOM THAT EVENING ON 3/15/2021 WENT TO BED WITH CHEST PAIN AND DID NOT WAKE UP THE NEXT MORNING PARAMEDICS WERE UNABLE TO REVIVE HIM, PRONOUNCED HIM DEAD AT THE SCENE. | 3/16/2021 | 3/13/2021 | 3/13/2021 | 0 |
| 1170822 | 4/6/2021 | 46 | M | Patient was found deceased on arrival in his living quarters after not showing up for work. This was approximately 14 days after his second pfizer vaccination. We have no reports of previous signs or symptoms in the days preceding his death. Patient had not visited the clinic since receiving his second shot in the series | 3/18/2021 | 3/4/2021 | 3/18/2021 | 14 | |
| 1176274 | 4/7/2021 | DC | 46 | F | Patient became SOB 911 called patient arrested in ambulance and died | 4/5/2021 | 3/25/2021 | 4/5/2021 | 11 |
| 1200939 | 4/13/2021 | VA | 46 | F | Massive PE, patient died. No history of DVT, we did a COVID test here and it was negative. She had no PMH, we suspect the vaccine made her hypercoagulable. Had pleuritic CP, tachycardia, tachypnea. | 4/6/2021 | 3/19/2021 | 4/6/2021 | 18 |
| 1205518 | 4/13/2021 | NJ | 46 | M | Resident was inoculated on 04/09. According to family members, he began to feel unwell that evening, cold sweats, high fever, dehydration. According to family members, he refused to get medical attention. After not hearing from him for a few days, family members called for a wellfare check on 04/12 at which time he was found deceased. | 4/12/2021 | 4/9/2021 | 4/10/2021 | 1 |
| 1214640 | 4/15/2021 | RI | 46 | M | After receiving the J&J vaccine on Sunday afternoon, when my husband got up on Monday morning he passed out in the bathroom and was unresponsive. The EMTs arrived and were able to revive him in the ambulance. When they reached the hospital he was put on life support. After he coded again in the Emergency room they told me he was without oxygen for too long and was taken off the respirator. He passed away at 4:10 PM. | 4/12/2021 | 4/11/2021 | 4/12/2021 | 1 |
| 1233510 | 4/20/2021 | MN | 46 | F | Death. Multiple pulmonary thrombi. | 4/19/2021 | 4/8/2021 | 4/19/2021 | 11 |
| 1267487 | 4/28/2021 | CA | 46 | M | Cough and diarrhea the day after receiving vaccine. The next day, had difficulty breathing and collapsed. | 4/26/2021 | 4/24/2021 | 4/26/2021 | 2 |
| 967240 | 1/22/2021 | MN | 47 | M | Patient unexpectedly died on o1/6/2020. No known signs or symptoms. | 1/6/2021 | 12/29/2020 | 1/6/2021 | 8 |
| 1021040 | 2/10/2021 | NE | 47 | M | Pfizer-BioNTech COVID-19 Vaccine Hospital Emergency Room Provider reported cause of death as COVID vaccine administered 11 days prior to death. Additional information being reported from LTCF. | 1/17/2021 | 1/6/2021 | 1/17/2021 | 11 |
| 1035641 | 2/17/2021 | KY | 47 | F | Healthcare was advised that this patient expired approximately two weeks after receiving her initial COVID vaccination | 2/9/2021 | 1/24/2021 | 2/9/2021 | 16 |
| 1051803 | 2/24/2021 | GA | 47 | F | unknown, was informed by Health Director that person had passed away | 1/15/2021 | 1/8/2021 | 1/15/2021 | 7 |
| 1058447 | 2/26/2021 | PA | 47 | M | Moderna COVID- 19 Vaccine EUA Patient was found deceased in the community near his home address on 2/24/21. The Medical Examiner's cause of death is currently listed as "Drug Intoxication - Accidental Overdose." Per the MEO, post mortem urine toxicology was positive for cocaine and fentanyl. His death is believed to be related to a cocaine product that was adulterated with fentanyl and is not believed to be related in any way to the Moderna COVID-19 vaccine. This was explicitly stated by the Medical Examiner's Office. | 2/23/2021 | 2/24/2021 | 1 | |
| 1065434 | 3/2/2021 | FL | 47 | M | Patient died; This is a spontaneous report from a contactable consumer (parent's patient). A 47-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via unknown route on 13Feb2021 (at the age of 47-year-old) at single dose for COVID-19 immunization. Relevant medical history and concomitant medications were not reported. On 18Feb2021 the patient died. The cause of death was unknown. An autopsy was not performed. No COVID prior vaccination. The patient had not been tested for COVID post vaccination. Information about lot/batch number has been requested.; Reported Cause(s) of Death: Patient died | 2/18/2021 | 2/13/2021 | 2/18/2021 | 5 |
| 1069728 | 3/3/2021 | TX | 47 | M | Patient Started having dizziness, feeling faint at around midnight on 3/3/2021. He then lost consciousness, had seizure-like activity and was taken to hospital via EMS. In the hospital patient was unresponsive and received resuscitation attempts unsuccessfully. Per family, after about 45 minutes, code was called and patient expired. | 3/3/2021 | 3/2/2021 | 3/3/2021 | 1 |
| 1133712 | 3/25/2021 | KY | 47 | F | reported bad headaches on the day following the vaccine--did not see the doctor--later died. the coroner reported that the preliminary autopsy showed an enlarged heart and liver | 3/24/2021 | 3/22/2021 | 3/24/2021 | 2 |
| 1156620 | 4/1/2021 | CO | 47 | M | Mandatory EUA Reporting - Patient received COVID-19 vaccine on 1/12/21 and then tested positive for Covid the same day. Was admitted to hospital from rehab (resides in rehab for chronic respiratory failure). Patient deteriorated throughout hospitalization, was transitioned to comfort care, and expired on 2/10/21. | 2/10/2021 | 1/12/2021 | 1/12/2021 | 0 |
| 1161106 | 4/2/2021 | 47 | F | CONTRACTED COVID, CONFIRMED 3/17/21, PATIENT DIED ON 3/23/21 | 3/23/2021 | 3/11/2021 | 3/17/2021 | 6 | |
| 1172648 | 4/6/2021 | CA | 47 | M | Cardiopulmonary arrest, D-Dimer 55,000, TNKase administered, ACLS, needle thoracostomy, persistent PEA arrest, decompensated into asystole , pronounced | 3/23/2021 | 3/16/2021 | 3/23/2021 | 7 |
| 1196666 | 4/12/2021 | ID | 47 | M | Pt. Expired | 3/15/2021 | 3/14/2021 | 3/15/2021 | 1 |
| 1199594 | 4/12/2021 | GA | 47 | F | There were no noted adverse signs or symptoms at the time of vaccination. Fiance of patient called Public Health on 4/12/21 to report the patient died in her sleep overnight on 4/7 or 4/8. Autopsy not performed, body embalmed prior to Public Health's knowledge of client death. Pfizer BioNTech COVID-19 Vaccine EUA | 4/8/2021 | 4/7/2021 | 4/8/2021 | 1 |
| 1212567 | 4/15/2021 | OR | 47 | M | he died while on his routine daily run; medical examiner agreed he should have an autopsy which showed coronary artery disease/likely an acute cardiac event | 4/11/2021 | 4/10/2021 | 4/11/2021 | 1 |
| 1213431 | 4/15/2021 | NY | 47 | F | Patient admitted with massive portal vein thrombosis and low plt in setting of infection. Symptoms started one week prior | 4/6/2021 | 3/1/2021 | 3/16/2021 | 15 |
| 1234152 | 4/20/2021 | MA | 47 | M | Pt. had (what we think) a small seizure on Thursday, March 18th and then again on Saturday, March 20th. On Sunday, March 21st, 911 had to be called as his seizure did not end. He had a grand male. He was seizing for several hours. At the time this was all occurring he has been on anti seizure meds for a few years Divalproex 1000 mg am and 1000 mgs pm daily). He passed 1 week later, March 28 at approx 6:45pm at the Clinic. I am unable to get any information on his medical report for that week. Statement from his Nurologists is on second page. Additional information for Item 18: Statement: 47 year old gentleman who passed away on March 28 from aspiration pneumonia secondary to status epilepticus and on a history of multiple sclerosis / additional leukoencephalopathy of unknown etiology (both treated with rituximab), prior seizures (on valproic acid) and pulmonary embolism (on apixaban). The key reason for reaching out is in light of the announcement about the side effects of the Johnson & Johnson vaccine specifically cerebral venous sinus thrombosis. While he had a known history of seizures, he had no clear trigger for these seizures; including that his valproic acid level was therapeutic (83.0 mcg/mL) at time of presentation. He had, however, received the Johnson & Johnson vaccine on March 12 before having what in hindsight appeared to be repeated seizures between March 18-21; he had a more significant one on March 21 that hospitalized him. This time frame appears consistent with the reported cases of central venous sinus thrombosis associated with the Johnson & Johnson vaccine. Equally, he was taking apixaban at that point in time and his PLT (173) / INR (1.1) / PTT (36.6) at time of presentation were all normal and stable. He did have an elevated ProBNP (552.0) at presentation; nasopharyngeal swab was negative for COVID / Influenza A/B / RSV and non-contrast head CT did not show any clear new abnormalities. His only D-dimer was obtained on March 23 and was 226. He did not have a CT angiogram or venogram. Overall the link between the vaccine and pt. seizures is not definite. At the same time, the similarity with the reported cases has led to me wanting to report it in case of the possible link. If you require further information then please don't hesitate to email me Pt. med list at the time of this incident Modifinil - 100 mg/1per day/AM Sertraline - 100 mg/1per day/AM Vitamin D3 - 50 mg/1per day/AM Divalproex - 500 mg/2per day/AM Eliquis - 5 mg/1per day/AM Furoseminde - 20 mg/1per day/AM Metroprolol - 100 mg/1per day/AM Lisinopril - 10 mg/1per day/AM Divalproex - 500 mg/2per day/PM Eliquis - 5 mg/1per day/PM Metroprolol - 100 mg/1per day/PM Melatonin - 5 mg/1per day/PM Quetiapine - 50 mg/3per day/PM | 3/28/2021 | 3/12/2021 | 3/18/2021 | 6 |
| 1238566 | 4/21/2021 | 47 | M | On April 18, 2021, nine days after the person got his second dose of Moderna vaccine, he committed suicide using a gun in the presence of his family. | 4/18/2021 | 4/9/2021 | 4/18/2021 | 9 | |
| 1268424 | 4/28/2021 | WI | 47 | F | The decedent was found in her bedroom by her daughter. Medical history only includes previous blood clots. Decedent has been complaining of coughing and shortness of breath the past few days. There is no history of drug use. The decedent had a foam cone when found. | 4/26/2021 | 4/24/2021 | 4/26/2021 | 2 |
| 1269763 | 4/29/2021 | NC | 47 | F | died on 14Apr2021 01:30 pm of a sudden death; first dose of BNT16B2 on 15Mar2021 09:00 am/ second dose via an unspecified route of administration on 02Apr2021; first dose of BNT16B2 on 15Mar2021 09:00 am/ second dose via an unspecified route of administration on 02Apr2021; This is a spontaneous report from a contactable healthcare professional (patient's spouse, nurse practitioner). A 47-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), second dose via an unspecified route of administration on 02Apr2021 (lot number: EW0150) as single dose (at the age of 47-years-old) for COVID-19 immunisation, vaccinated at a hospital. Medical history included hypothyroidism, anxiety, and chronic migraine (ongoing). The patient had no known food and drug allergies. Concomitant medications included levothyroxine sodium (SYNTHROID); sumatriptan for migraines; and clonazepam for anxiety. The patient received the first dose of BNT16B2 on 15Mar2021 09:00 am (lot number: EN6708) (at the age of 47-years-old) for COVID-19 immunization. The patient had no other vaccine in four weeks. The patient had no COVID prior to vaccination. The patient died on 14Apr2021 01:30 pm of a sudden death. She was found at home unresponsive and pulseless. Efforts at resuscitation were unsuccessful. Her medical history of hypothyroidism, anxiety and chronic migraines do not appear to be contributory. The patient did not receive treatment (as reported). The reporter considered the event to be a serious adverse effect (SAE). A full autopsy has been performed; the results were pending.; Reported Cause(s) of Death: died on 14Apr2021 01:30 pm of a sudden death | 4/14/2021 | 4/2/2021 | 4/2/2021 | 0 |
| 1273940 | 4/30/2021 | FL | 47 | F | Heart Attack at 7:10 am( 4/9/21), CPR, CCU, CPR, Death(4/11/21) 9:15pm | 4/11/2021 | 4/9/2021 | 4/11/2021 | 2 |
| 1283686 | 5/3/2021 | HI | 47 | F | Patient discovered by caregiver to have passed away on the morning of 4/24/21 | 4/24/2021 | 4/23/2021 | 4/24/2021 | 1 |
| 1288833 | 5/5/2021 | NC | 47 | F | My wife (age 47) died on 14Apr2021 of a sudden death. She was found at home unresponsive and pulseless. Her medical history is non-contributory for a sudden cardiac death. A full autopsy is pending. | 4/14/2021 | 4/2/2021 | 4/14/2021 | 12 |
| 939270 | 1/12/2021 | HI | 48 | M | Sudden cardiac death | 12/31/2020 | 12/22/2020 | 12/31/2020 | 9 |
| 981407 | 1/28/2021 | MO | 48 | F | Expired in sleep on 1/24/21 | 1/24/2021 | 1/6/2021 | 1/24/2021 | 18 |
| 994913 | 2/2/2021 | TN | 48 | F | patient passed away 2 days after vaccine. patient had temperature, nausea, and vomiting after vaccine. | 2/1/2021 | 1/30/2021 | 1/31/2021 | 1 |
| 1046179 | 2/22/2021 | OH | 48 | F | patient was not vaccinated at hospital. Caregiver reports that patient was vaccinated with second dose on Monday 2/15/21. Tuesday patient experienced n/v/d. Went to an ED on Wednesday and was cleared and sent home. Thursday reported shortness of breath to her caregiver and then collapsed. Patient was brought to as PEA arrest and ultimately died. | 2/18/2021 | 2/15/2021 | 2/16/2021 | 1 |
| 1068993 | 3/3/2021 | WA | 48 | F | Spontaneous intracerebral hemorrhage and death on 2/20/2021 | 2/20/2021 | 1/23/2021 | 2/20/2021 | 28 |
| 1096497 | 3/13/2021 | FL | 48 | M | Notified by police department that patient was found dead at his home on 3/12/21. Per the officer, the family reports patient reported diarrhea on 3/11/21 and fatigue on 3/12/21. The family found him in his home deceased later in the day on 3/12/21 | 3/12/2021 | 3/11/2021 | 3/12/2021 | 1 |
| 1135730 | 3/26/2021 | FL | 48 | M | Patient found dead two days after vaccination; A spontaneous report was received from a healthcare provider concerning 48-year-old, male patient who received Moderna's COVID-19 vaccine (mrna-1273) and died. The patient's medical history includes bipolar disorder, colon polyps, hypertension, benign tremors & other Comorbidities. Concomitant product like iron sulfate, Fluticasone, Gabapentin, Lamotrigine, Methocarbamol, Propranolol hydrochloride was reported by the reporter . On 11 mar 2021, approximately 2 days prior to the event, the patient received their first dose of two planned doses of mRNA-1273 (Batch number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On 13 Mar 2021, the patient died. No other details were reported. Treatment information was unknown. The patient died on 13 Mar 2021. The cause of death was not provided. Plans for an autopsy were unknown.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death | 3/13/2021 | 3/11/2021 | 3/13/2021 | 2 |
| 1152759 | 3/31/2021 | NE | 48 | F | 7 AM 3/25/2021 - Patient called out to husband from the bathroom where she experienced a syncopal event, then passed out. An ambulance was called and she was revived for a short period of time. She was taken to Hospital where she coded 3 times. She was then life-flighted to second Hospital. According to the hospital records, tests conducted over the course of several days determined that she had no neurological activity. Initial reports in the records indicate pulmonary embolism, cardiac and respiratory arrest. She was on life support for the remainder of her time. Organ donation is being pursued at present and results of this are pending at time of this report submission. Date of death is unknown until organ retrieval is accomplished. Family will be contacted in the next few days to ask further questions about any other kinds of vaccine-related reactions that may have happened more immediately to days after the vaccination on 3/17/2021. A co-worker thought that she had shortness of breath for 3-4 days before this critical event occurred on 3/25/2021. | 3/17/2021 | 3/25/2021 | 8 | |
| 1154856 | 3/31/2021 | SC | 48 | F | My sister died due to allergic reaction 45min after taking the Moderna Vaccine | 3/29/2021 | 3/29/2021 | 3/29/2021 | 0 |
| 1199575 | 4/12/2021 | CA | 48 | M | Death | 4/9/2021 | 4/7/2021 | 4/9/2021 | 2 |
| 1202482 | 4/13/2021 | TX | 48 | F | blood clots | 4/12/2021 | 4/6/2021 | 4/12/2021 | 6 |
| 1208419 | 4/14/2021 | CA | 48 | M | Patient described throwing up, pale in skin, sweating prior to passing away. | 4/12/2021 | 3/13/2021 | 4/12/2021 | 30 |
| 1223683 | 4/17/2021 | NY | 48 | F | Patient reported severe headache on 2/12/21 at approximately 3:30 pm followed by vertigo, nausea, vomiting. Patient became unconscious and EMS was called, found patient on floor and she was brought to ED where CT revealed intracranial hemorrhage. Patient was admitted and supportive care given. She had worsening status on 2/17/21 with pupillary reflexes no longer present and withdrawal of care was performed on 2/21/21. Patient expired on 2/22/21. | 2/22/2021 | 1/27/2021 | 2/12/2021 | 16 |
| 1256112 | 4/25/2021 | AZ | 48 | M | My husband received the shot on the 22nd. He died in his sleep on the 24th. He was complaining how the second shot really was giving him a lot of trouble, but nothing that would indicate life-threatening symptoms | 4/24/2021 | 4/22/2021 | 4/24/2021 | 2 |
| 1267074 | 4/28/2021 | OH | 48 | M | #1 = 011J20A on 1-6-21 #2 = 028L20A on 2-3-21 patient presented after sudden onset of chest pain early in morning and found to be covid +. ECG demonstrated diffuse ST elevation, troponins negative. CT without contrast didn't have much in it. He was found to be COVID rapid test+ and IGG negative. He was admitted into isolation, no oxygen needs. DDIMER was over 2000 and friction rub noted on physical exam. Cardiology ruled out STEMI, thought maybe viral pericarditis - but wanted echo done after out of isolation. CTA was planned for AM on 4-28-21, but patient died 4-27-21 PM after being found down in room. ROSC was not able to be achieved despite aggressive resuscitation efforts | 4/27/2021 | 2/3/2021 | 4/26/2021 | 82 |
| 1304434 | 5/10/2021 | NM | 48 | M | Patient found dead after receiving vaccine. At 11:44 on 3-30-2021 Medical Investigator was able to return call after leaving scene where there was no phone service. Police were on the scene requesting Medical Investigator Contact was made between Medical Investigator and member of the police force. Narrative was that the patient, who is handicap with considerable health issues which he was born with, and his parents had been to healthcare facility to receive COVID vaccination. Returning they had traveled in order to arrive at their residence. The decedent had asked to be dropped off close to parents home. The parents arrived at the residence and after waiting ten to fifteen minutes walked searching for the decedent. He was located unresponsive and 911 was initiated. | 3/30/2021 | 3/30/2021 | 3/30/2021 | 0 |
| 1310622 | 5/12/2021 | OH | 48 | M | Developed symptoms around 4/25, presented to ED with complaints of chest pain and something being stuck in his throat. Subsequently died on 4/27. | 4/27/2021 | 1/6/2021 | 4/26/2021 | 110 |
| 950057 | 1/16/2021 | AL | 49 | F | Patient suffered a cardiac arrest and was unable to give details about her symptoms. Per husband, patient did not complain of any symptoms after vaccine administration. She began seizing without warning which was complicated by cardiac arrest of uncertain etiology | 1/15/2021 | 1/15/2021 | 1/15/2021 | 0 |
| 1126015 | 3/23/2021 | MN | 49 | F | Unknown adverse event from vaccination. 3/14/21 Informed by caregiver that client was sent by ambulance to ER and diagnosed with bilat pneumonia. She developed difficulty breathing on 3/13/21. She was seen at Walk In on 3/12/21 for toenail eviscerated and INR, and had been giving tylenol for pain control for toe. 3/15/21 Informed by caregiver client was in ICU, septic, bilat pneumonia, and low oxygen levels. 3/16/21 Informed by caregiver client not doing well authorized indwelling cath due to low blood pressure and ventilator. Client transfered by med flight to ICU. 3/17/21 Informed by caregiver client death last night. | 3/16/2021 | 3/9/2021 | 3/13/2021 | 4 |
| 1130616 | 3/24/2021 | MD | 49 | F | Community partner reported that they found her unresponsive on the 17th (so she may have died on the 16th) from what they believe was a heart attack. The family has requested an autopsy. | 3/17/2021 | 3/16/2021 | 3/17/2021 | 1 |
| 1178531 | 4/7/2021 | CO | 49 | M | Death within 12 hours | 4/4/2021 | 4/4/2021 | 4/4/2021 | 0 |
| 1209498 | 4/14/2021 | NY | 49 | M | Pt received the vaccine on 3/24/21. On 4/12/21 pt died of cardiac arrest | 4/12/2021 | 3/24/2021 | 4/12/2021 | 19 |
| 1215403 | 4/15/2021 | OR | 49 | M | 1 week post vaccination - patient, not responding to albuterol HFA, called 911, he passed out, was unresponsive, pronounced dead. | 4/14/2021 | 4/7/2021 | 4/14/2021 | 7 |
| 1221176 | 4/16/2021 | OR | 49 | U | he died; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (he died) in a 49-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included No adverse event (No reported medical history). On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. Death occurred on 03-Apr-2021 The patient died on 03-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. No concomitant medications were reported. No treatment medications were reported. Action taken with mRNA-1273 in response to the event was not applicable. Very limited information regarding this event has been provided at this time. Further information has been requested; Sender's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested; Reported Cause(s) of Death: Unknown cause of death | 4/3/2021 | 3/30/2021 | 4/3/2021 | 4 |
| 1235822 | 4/21/2021 | NY | 49 | F | microangiopathic hemolytic anemia; thrombocytopenia; severe hyperbilirubinemia/cholestasis with coagulopathy; severe hyperbilirubinemia/cholestasis with coagulopathy; severe hyperbilirubinemia/cholestasis with coagulopathy; thrombotic microangiopathy; jaundice; nausea; vomiting; diarrhea; This is a spontaneous report from a contactable physician. A 49-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular, administered in Arm Left on 29Mar2021 13:45 (Batch/Lot Number: ER8733) as single dose for covid-19 immunisation. Patient was not pregnant. The COVID-19 vaccine was administered at Doctor's office/urgent care. Medical history included Metastatic breast cancer. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant Therapy included Clinical trial oral drug - ARV-471 on 22Mar2021. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient presented to the hospital on 05Apr2021 complaint of (c/o) 1 week of jaundice, nausea, vomiting, and diarrhea, which started on an unknown date in Mar2021, and on 05Apr2021 found to have evidence of microangiopathic hemolytic anemia, thrombocytopenia, and severe hyperbilirubinemia/cholestasis with coagulopathy. Work-up revealed like thrombotic microangiopathy although etiology unclear. ADAMTS13 level 29 with no inhibitor not suggestive of Thrombotic thrombocytopenic purpura (TTP). Patient eventually died of this acute presentation. She also had a history of metastatic breast cancer and had also just started taking a phase 1/2 oral clinical trial drug ARV-471 on 22Mar2021. Unclear if the drug, COVID vaccine, or breast cancer may have contributed to current illness. Adverse event resulted in: Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Prolongation of existing hospitalization (vaccine received during existing hospitalization), Life threatening illness (immediate risk of death from the event), Patient died. Patient hospitalized for 5 days. Date of Death was on 09Apr2021. Death cause: Death certificate stated metastatic breast cancer. No autopsy performed. Therapeutic measures were taken as a result of events included plasmapheresis, steroids, antibiotics. The patient underwent lab tests and procedures which included Nasal Swab: negative on 05Apr2021. The outcome of the events was fatal.; Sender's Comments: Based on temporal association and the limited information available, the causal association between BNT162B2 vaccine and the reported events cannot be completely excluded. 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 RAs, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: severe hyperbilirubinemia/cholestasis with coagulopathy; jaundice; nausea; vomiting; diarrhea; microangiopathic hemolytic anemia; thrombocytopenia; severe hyperbilirubinemia/cholestasis with coagulopathy; severe hyperbilirubinemia/cholestasis with co | 4/9/2021 | 3/29/2021 | 3/1/2021 | |
| 1240207 | 4/22/2021 | CA | 49 | F | Symptoms of tiredness and head sinus pressure came on throughout the day monday 3-29-21. Symptoms were unchanged tues morning 3-30-21. She died Tuesday 3-30-21 between 10:34 am and 12:00 pm. She was found unresponsive at 12:07 pm when husband returned home for lunch. Autopsy results still pending. | 3/30/2021 | 3/18/2021 | 3/29/2021 | 11 |
| 1255612 | 4/25/2021 | CA | 49 | M | Heart attack and death; This is a spontaneous report from a contactable Nurse. A 49-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: Ej1685) intramuscular in left arm on 18Dec2020 at 11:00 AM at single dose for COVID-19 immunisation. Medical history was none, no known allergies. No other concomitant medications in two weeks. No other vaccine in four weeks. The patient experienced heart attack at 05:30 pm on 06Apr2021 and the event caused patient death. No treatment for the event. Autopsy results was available. Autopsy remarks: heart attack. No COVID prior vaccination, no COVID tested post vaccination. The patient died on 06Apr2021. An autopsy was performed and the reported cause of death was heart attack.; Sender's Comments: Myocardial infarction occurred 3 months and 19 days after BNT162B2 vaccine administration. The event is considered unrelated to suspect drug being rather an incidental occurrence. 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 Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Heart attack and death; Autopsy-determined Cause(s) of Death: Heart attack | 4/6/2021 | 12/18/2020 | 4/6/2021 | 109 |
| 1257062 | 4/25/2021 | IL | 49 | M | The patient developed high fevers, profound watery diarrhea up to 13L/day, requiring IV administration of replacement fluids. He ultimately developed ARDS and succumbed to this illness. | 4/23/2021 | 4/16/2021 | 4/17/2021 | 1 |
| 1286144 | 5/4/2021 | NY | 49 | M | Shortness of breath followed by sudden collapse followed by death. | 4/23/2021 | 4/21/2021 | 4/23/2021 | 2 |
| 1288450 | 5/5/2021 | PA | 49 | F | Feeling Tired; Headaches; Passed away; found dead in her bed; Was not feeling well; This is a spontaneous report from a contactable consumer. A 49-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 2 via an unspecified route of administration on 11Apr2021 (lot number: ER8729) at the age of 49 years old, as single dose for COVID-19 immunisation. The patient's medical history was not reported. Concomitant medications included naproxen sodium (NAPROSYN) taken for an unspecified indication from 05Apr2021 to an unspecified stop date; and benzonatate taken for an unspecified indication from 05Apr2021 to an unspecified stop date. The patient previously received first dose of BNT162b2 on 21Mar2021 (lot number: EP6955) at the age of 49 years old, for COVID-19 immunization and experienced fatigue, legs were hurting, dry cough, and really bad headaches. No other vaccines received in four weeks. The caller's friend (patient) got her second dose on a Sunday (11Apr2021). Monday, (12Apr2021), the patient went to work, but left because she wasn't feeling well. The reporter stated that the reporter did not speak to her friend (patient) directly on this day but was told that her friend (the patient) was feeling tired and having headaches. The reporter stated that her friend died early Tuesday morning 13Apr2021. The patient underwent lab tests and procedures which included COVID-19 PCR test: negative on 05Apr2021. The patient died on 13Apr2021. An autopsy was performed, and results were not provided. Outcome of events 'was not feeling well', 'feeling tired', and 'headaches' was unknown.; Reported Cause(s) of Death: Passed away; found dead in her bed | 4/13/2021 | 4/11/2021 | 4/12/2021 | 1 |
| 1301965 | 5/10/2021 | SC | 49 | F | DEATH; This spontaneous report received from a company representative concerned a 49 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2. s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, frequency 1 total, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 27-APR-2021, the patient died from unknown cause of death after 4 weeks of Johnson and Johnson vaccination. An autopsy was performed on an unspecified date and there was no sign of high blood pressure, heart disease, or diabetes to patient as per report. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender's Comments: V0. 20210505962-covid-19 vaccine ad26.cov2.s -Death. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH; Autopsy-determined Cause(s) of Death: UNKNOWN CAUSE OF DEATH | 4/27/2021 | 4/27/2021 | ||
| 1302383 | 5/10/2021 | TX | 49 | M | He felt very bad the night he received the 2nd shot of Pfizer covid-19 vaccine on April 27. He even joked he probably would die that night. He also complained that despite his protest, the person who administered the shot insisted to inject on his shoulder joint. He developed a bigger-than-quarter-size bruise on his right inner arm the next day. He was feeling tired the following days. On May 4 around 3:30, I heard he was making loud noises. I came to his side immediately. At the time I thought he was making louder than usual snores. I nudged him gently but he didn't respond. After about 15 seconds, the sound stopped, and he had no breath. I then called 911 within 10 seconds, tried to do CPR on him. It took EMS 6 minutes to arrive even though we live very close to a fire station in a well-accessed urban area. EMS worked on him for about 30 minutes before transported him to hospital. They continued to work on him for a while. He never regained breath. | 5/4/2021 | 4/27/2021 | 5/4/2021 | 7 |
| 1302428 | 5/10/2021 | MD | 49 | M | The patient was last seen well at 3:30 PM. He was found unresponsive, face down in his own vomit, cyanotic, apneic by family. Patient was unable to be resusitated. He was pronounced dead at 6:51 PM. | 5/5/2021 | 5/5/2021 | 5/5/2021 | 0 |
| 1302705 | 5/10/2021 | 49 | U | This 49 year old female received the Covid shot on 4/6 /21 and went to the ED on 5/5 /21 with the following diagnoses listed below and died on 5/5/21. | 5/5/2021 | 4/6/2021 | 5/5/2021 | 29 | |
| 1307384 | 5/11/2021 | MI | 49 | M | Was feeling fine the day before, went to sleep around midnight and passed away during the night while sleeping. | 3/11/2021 | 5/8/2021 | 58 | |
| 918518 | 1/4/2021 | NE | 50 | F | syncopal episode - arrested - CPR - death | 12/31/2020 | 12/31/2020 | 12/31/2020 | 0 |
| 955597 | 1/19/2021 | NE | 50 | M | Death | 1/15/2021 | 1/13/2021 | 1/15/2021 | 2 |
| 1002418 | 2/4/2021 | PA | 50 | F | Patient death | 2/4/2021 | 1/15/2021 | 2/4/2021 | 20 |
| 1088830 | 3/10/2021 | TX | 50 | M | Patient died after feeling unwell for about ten minutes. | 3/8/2021 | 3/3/2021 | 3/8/2021 | 5 |
| 1098119 | 3/14/2021 | NE | 50 | F | in the early am she had bad diarrhea , she went to work and then started having really bad stomach pains and before noon she had to go home because she started puking. She laid down to take a nap around 3:30pm and never woke up. | 2/1/2021 | 1/22/2021 | 2/1/2021 | 10 |
| 1118314 | 3/20/2021 | PA | 50 | F | She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021. Her autopsy is pending. | 3/14/2021 | 3/10/2021 | 3/10/2021 | 0 |
| 1127175 | 3/23/2021 | 50 | F | Death | 3/20/2021 | 3/3/2021 | 3/20/2021 | 17 | |
| 1129427 | 3/24/2021 | OH | 50 | M | Pt received vaccine on Friday, March 19th. On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest. BLS done on scene, transported to local ER where pt was pronounced dead. | 3/22/2021 | 3/19/2021 | 3/22/2021 | 3 |
| 1138370 | 3/26/2021 | AZ | 50 | M | he started feeling sick day after vaccine with flu like symptoms, seen in ED 5 days after vaccination, diagnosed with COVID19, About 1 week after that, he was found dead at home on his couch. | 3/17/2021 | 3/4/2021 | 3/5/2021 | 1 |
| 1151500 | 3/31/2021 | VA | 50 | M | Found unresponsive by family member after falling asleep. Started CPR .Rescue squad arrived. Transported to Hospital. Cease resuscitation order at 1:32 am. | 3/19/2021 | 3/18/2021 | 3/19/2021 | 1 |
| 1168240 | 4/5/2021 | MO | 50 | M | Patient deceased 3/23/21 due to suicide. | 3/23/2021 | 3/18/2021 | 3/23/2021 | 5 |
| 1169584 | 4/5/2021 | NC | 50 | F | Patient appeared in no distress the day after vaccination other than complaint of nausea. It is unclear but patient expired sometime the night of 4/3/21 or early morning of 4/4/21 | 4/3/2021 | 4/2/2021 | 4/3/2021 | 1 |
| 1179444 | 4/8/2021 | RI | 50 | F | Systemic: Unknown, patient found deceased at home evening after receiving vaccine.-Severe, Additional Details: called pharmacy inquiring about vaccine for patient. She received her COVID vaccine on 4/6/21 and later that evening was found at home deceased. Called to gather information on the patient/vaccine. Caregiver stated that the patient did not have a PCP, therefore they do not have much medical history on her. There were no notes on adverse reaction during post-vaccine observation. It is unknown at this time if vaccine played any role. | 4/6/2021 | 4/6/2021 | 4/6/2021 | 0 |
| 1202366 | 4/13/2021 | AL | 50 | F | pt recieved vaccine at 1135 on 4/9, pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518, was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later, after multiple cardiac arrests and multiple rounds of ACLS were performed, the pt was pronounced dead at 0127 on 4/12 | 4/12/2021 | 4/9/2021 | 4/10/2021 | 1 |
| 1212295 | 4/15/2021 | KY | 50 | F | Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking "out of her head", fever, chills, leg pain, "bad" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS. | 4/9/2021 | 4/6/2021 | 4/7/2021 | 1 |
| 1221425 | 4/16/2021 | IN | 50 | M | Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to "do him in." He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021 | 4/11/2021 | 3/18/2021 | 3/19/2021 | 1 |
| 1229552 | 4/19/2021 | AL | 50 | F | We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day. She was encouraged to receive the vaccine at the encouragement of her oncologist. | 4/17/2021 | 4/16/2021 | 4/16/2021 | 0 |
| 1247180 | 4/23/2021 | MD | 50 | F | Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I'm told tests of samples are ongoing. | 4/4/2021 | 3/17/2021 | 4/4/2021 | 18 |
| 1258763 | 4/26/2021 | OH | 50 | F | On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs. | 4/23/2021 | 4/17/2021 | 4/23/2021 | 6 |
| 1260018 | 4/26/2021 | FL | 50 | M | Was sweaty, unresponsive, and breathing shallow a few mins after administration. BP 97/68. Within a few mins, patient became responsive and BP 146/81. Patient chose not to go with EMS and walked out of store after they were feeling better. Today (3 days later) received report from medical examiner that patient passed away. | 4/1/2021 | 4/23/2021 | 4/23/2021 | 0 |
| 1266953 | 4/28/2021 | 50 | M | It was reported that patient had been experiencing difficulty breathing, walking and delusions as per his fiancé . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty. | 4/1/2021 | 3/16/2021 | 4/1/2021 | 16 | |
| 1270749 | 4/29/2021 | FL | 50 | M | HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS | 4/24/2021 | 4/23/2021 | 4/23/2021 | 0 |
| 1271786 | 4/29/2021 | WI | 50 | F | Patient came to pharmacy for 1st Moderna Covid-19 vaccination on 4/21/21. Spouse reported she died on 4/25/21. Our pharmacy does not have information about her medications or health conditions as she wasn't a regular customer of ours. | 4/25/2021 | 4/21/2021 | 4/25/2021 | 4 |
| 1280622 | 5/2/2021 | SC | 50 | M | On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed. On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS. | 5/1/2021 | 4/28/2021 | 5/1/2021 | 3 |
| 1304689 | 5/10/2021 | PA | 50 | M | Blood clot | 4/22/2021 | 4/1/2021 | 4/14/2021 | 13 |
| 1310861 | 5/12/2021 | CT | 50 | M | Cardiac Arrest, Death | 5/10/2021 | 5/9/2021 | 5/10/2021 | 1 |
| 938118 | 1/12/2021 | MI | 51 | F | on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke, aneurysm | 1/10/2021 | 1/5/2021 | 1/8/2021 | 3 |
| 946293 | 1/15/2021 | VA | 51 | M | 51 year old M with h/o O2 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 1800hours 1/7/2021. He was transported to hospital for acute on chronic hypoxia respiratory failure. On 1/12/2021 he decompensated further, and after discussing with family and palliative care, He was changed to comfort care. He expired on 1/12/2021@2325 at medical center. | 1/12/2021 | 1/7/2021 | 1/7/2021 | 0 |
| 955532 | 1/19/2021 | NJ | 51 | F | COVID 19 Vaccination administered by pharmacy staff. No adverse effect at the present time. Staff will continue to observe adverse reaction. Will continue to monitor. Patient at start of shift awake in the bed. Pt at 3am was on the commode leaned to the side. Patient body still warm to touch no pulse. Called for assistance Asap. Cpr started promptly. Cpr given patient on floor 911 arrived at the scene at 3:10am Cpr rotated Between Nursing and EMT on Scene. Cpr was given to patient for over 45 minutes. Patient was pronounced at the scene at 3:50am. Call placed to Pt family by supervisor on shift. MD to be notified. AT 3:00am, I was notified by the nurse that resident is unresponsive. Upon entering room, resident was sitting on the commode unresponsive with absent respiration and pulse. Resident lowered down on the floor with 4 person assist. CPR initiated, AED pads placed on chest with no shock indicated. 911 called and EMT and paramedics arrived around 3:10am. ACLS performed until code stopped and pronounced death at 3:48am. I called and notified family member of his demise and awaiting for family to call us back for funeral arrangements. | 1/13/2021 | 1/12/2021 | ||
| 979309 | 1/27/2021 | NV | 51 | F | Systemic: patient had no known medical history per supervisor | 1/22/2021 | 1/22/2021 | 0 | |
| 995977 | 2/2/2021 | VA | 51 | M | Lethargy/altered level of consciousness lead to hospital admission. Multiple interventions during hospitalization. Final hospital diagnoses: Acute respiratory failure with hypercapnia, acute pansinusitis. | 1/27/2021 | 1/19/2021 | 1/25/2021 | 6 |
| 1006662 | 2/5/2021 | TX | 51 | F | Pt had 2nd vaccine, went home and started having "cramping" in all of her muscles. It became bad enough that she was taken to local ED where she then started coughing up blood, required intubation and about 6 hrs later, died. | 1/22/2021 | 1/22/2021 | 1/22/2021 | 0 |
| 1032163 | 2/15/2021 | GA | 51 | F | Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura with pain and weakness. Palliative care consulted. Patient passed away on 2/11. | 2/11/2021 | 1/16/2021 | 2/1/2021 | 16 |
| 1042012 | 2/19/2021 | NY | 51 | F | Patient died suddenly 2/14/2021 | 2/14/2021 | 2/1/2021 | 2/14/2021 | 13 |
| 1049773 | 2/23/2021 | GA | 51 | F | Patient died on 02/20/2021. Cause of death was pulmonary embolism. | 2/12/2021 | |||
| 1095435 | 3/12/2021 | TX | 51 | F | Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27 | 1/27/2021 | 1/11/2021 | 1/25/2021 | 14 |
| 1114822 | 3/19/2021 | LA | 51 | F | Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine. Eventually died from complications of COVID. Because vaccine was administered prior to her illness, I am putting this in the VAERS system. Symptoms included SOB, coughing, muscle aches. headache, fever. | 1/31/2021 | 12/30/2020 | 12/31/2020 | 1 |
| 1122741 | 3/22/2021 | MO | 51 | M | suspected pulmonary embolism; shock; cardiac arrest; This is a spontaneous report from a non-contactable consumer (patient's wife). A 51-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, unknown lot number and expiration), via an unspecified route of administration on 04Mar2021 at 11:45 AM at a single dose for COVID-19 immunization. Medical history reported as none. The patient has no known allergies. The patient's concomitant medications were not reported. The patient experienced a suspected pulmonary embolism on Monday 08Mar2021 at 11:30 AM. Embolism led to shock and cardiac arrest. The patient did not have COVID prior to vaccination and was not tested for COVID post vaccination. The patient did not receive other vaccine in four weeks. The patient received unspecified treatment for the events. The patient died on 08Mar2021 at 11:30 AM. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: suspected pulmonary embolism; shock; cardiac arrest | 3/8/2021 | 3/4/2021 | 3/8/2021 | 4 |
| 1130386 | 3/24/2021 | KY | 51 | M | syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021 | 3/17/2021 | 2/24/2021 | 3/1/2021 | 5 |
| 1133010 | 3/25/2021 | 51 | M | shortness of breath; weakness; diffuse chest tightness; confusion; dizziness; cardiac failure; pulmonary failure; A spontaneous report was received from a consumer concerning a 51-year-old, male patient who developed cardiac failure, pulmonary failure/respiratory failure and died. The patient's medical history included hypertension, obesity, bee allergy and bipolar disorder. Concomitant product use was not provided by the reporter. Patient received first dose of vaccine prior to two weeks to his death (died on 09 Mar 2021). A week prior to his vaccination as shortness of breath, weakness, diffuse chest tightness, confusion, and dizziness. These symptoms progressed following his vaccination and he was hospitalzed for two days prior to his death on 09 Mar 2021. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not applicable. The patient died on 09 Mar 2021 The cause of death was reported as cardio/pulmonary failure with secondary and tertiary causes of hypertension and obesity. Plans for an autopsy were not provided. The outcome of the events, cardiac failure and pulmonary failure were fatal.; Reporter's Comments: This is a case of death in a 51-year-old male subject with a medical history of HTN, obesity, bee allergy and bipolar disorder,who died 7 days after receiving first dose of vaccine. Very limited information has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: cardiac failure; pulmonary failure | 3/9/2021 | 3/9/2021 | |||
| 1134697 | 3/25/2021 | TX | 51 | M | Patient reportedly passed away on 3-24-21 on the day after the vaccine was given. We have no further information at our facility regarding the event. | 3/24/2021 | 3/23/2021 | 3/24/2021 | 1 |
| 1134819 | 3/25/2021 | MD | 51 | F | She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending. | 3/17/2021 | 3/4/2021 | 3/11/2021 | 7 |
| 1155829 | 4/1/2021 | NV | 51 | M | Cardiopulmonary arrest and death at 0822 4/1/21 | 4/1/2021 | 3/24/2021 | 3/24/2021 | 0 |
| 1158952 | 4/2/2021 | FL | 51 | M | Death of patient reported to have happened on 3/30/2021 | 3/30/2021 | 2/18/2021 | 3/30/2021 | 40 |
| 1177076 | 4/7/2021 | KS | 51 | F | On Saturday, April 3rd, patient told her son she was tired and was going to take a nap. Her son tried to wake her the next morning since she had not come out of her room from the day before. He was unable to wake her. | 4/4/2021 | 3/30/2021 | 4/3/2021 | 4 |
| 1194264 | 4/11/2021 | MD | 51 | M | Patient found deceased. Unwitnessed death. | 4/10/2021 | 4/8/2021 | 4/9/2021 | 1 |
| 1215882 | 4/15/2021 | OH | 51 | F | fatal pulmonary embolism from RLE DVT | 4/14/2021 | 4/1/2021 | 4/14/2021 | 13 |
| 1216134 | 4/15/2021 | OH | 51 | F | Cardiac arrest...death | 4/4/2021 | 3/19/2021 | 4/4/2021 | 16 |
| 1236417 | 4/16/2021 | 51 | M | death Narrative: Patient with noted history of ALS was given Moderna covid vaccine #1 on 2/27/21. On 3/5/21, notes were entered in system for family requesting a specialty bed as he was having difficulty sleeping as it was hard to breath when he laid down. He was sleeping sitting up in his wheelchair. On 3/8/21, a note was placed that he was planned to have a trach placed on 3/12/21 and that he was now under hospice care. No further notes entered and a date of death was recorded as 3/17/21. No autopsy results available. 18 days from date of vaccine to date of death. | 3/17/2021 | 2/27/2021 | 3/17/2021 | 18 | |
| 1227980 | 4/19/2021 | TX | 51 | M | Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer. A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation. Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date. The patient died on 02Apr2021. An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it's too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he's a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it's better, by Friday he was making breakfast, fell and died. With his girlfriend she said what's going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain | 4/2/2021 | 3/27/2021 | 3/1/2021 | |
| 1241587 | 4/22/2021 | NC | 51 | F | She was a healthcare worker. It was reported to me by her immediate supervisor that she tested positive for COVID-19 the day after her first vaccination. She became symptomatic around January 21, 2021. She was scheduled to return to work on January 29, 2021 but did not come in. She died on February 2, 2021. | 2/2/2021 | 1/14/2021 | 1/21/2021 | 7 |
| 1288451 | 5/5/2021 | FL | 51 | F | Unknown cause of death; Cataract; This is a spontaneous report from a contactable consumer from a Pfizer-sponsored program. A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration in Oct2020 (Batch/Lot number was not reported) as a single dose for COVID-19 immunization. Medical history included ongoing diabetes mellitus-diagnosed 10-15 years ago, ongoing asthma-all her life, Allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes), and obesity. The patient's concomitant medications were not reported. The patient had a cataract surgery a couple of weeks prior on an unspecified date and on 21Apr2021, died of unknown cause. The reporter's mother was part of one of the clinical trial groups for the Pfizer COVID vaccine, and she died suddenly and unexpectedly last week. They did blood work with her family physician last week. It was fine. They didn't believe it was something she had going on. There were no indicators for why she died. She had lost a lot of weight, but she was trying to lose weight - she had been trying the past 3-4 years. Her blood work at the doctor before she died was the best her blood work had been in years. She had a physical, the week previous with our family doctors and the doctor had no reason to suspect that anything was about to happen. Medical examiner basis, they say because there is no drug overdose, they declined to do autopsy, but she has been part of trial and just dying suddenly unexpectedly. The family doctor doesn't know what to put on the death certificate. There were no drugs and no foul play involved so they won't do an autopsy. She was in the Pfizer clinical trial group. The doctor's office is supposed to report through CDC. His father reached out yesterday to the clinic group, but they haven't heard anything back. He is unsure of the exact dates she was given the vaccine. He thinks the first one was Sep2020, and the last one was Oct2020. Later on, she did receive paperwork that she did receive the vaccine, and not the placebo. It told her she got the vaccine and didn't need to be revaccinated. He is wondering if Pfizer will do an autopsy to see why she passed. His mom wanted to be cremated so once that happens, there won't be much information at that point. They are trying to hold off to see if Pfizer wants to do an autopsy. The doctor has no clue what happened. The doctor doesn't know what to put on the death certificate. At 2:45, 2:50, and 3:06 her fit bit just stopped. She has been at the funeral home since Wednesday. He is sure the funeral home would like to get started with something. They can't move forward with cremation until they know for sure. Therapeutic measures were taken as a result of cataract. The outcome of the event cataract was unknown. The patient died on 21Apr2021. Autopsy was not performed. Information on the batch/lot number has been requested.; Reported Cause(s) of Death: Unknown cause of death | 4/21/2021 | 10/1/2020 | ||
| 1292213 | 5/6/2021 | TN | 51 | F | DEATH. My sister took the vaccine on April 28th and DIED on May 3rd. | 5/3/2021 | 4/28/2021 | 5/3/2021 | 5 |
| 1296012 | 5/7/2021 | NE | 51 | M | Arrived to emergency department via ambulance from nursing home with complaints of "looking like he was about to have a seizure". Patient became unresponsive and a code was called. ACLS performed but the patient did not recover from cardiac arrest. | 5/6/2021 | 5/6/2021 | 5/6/2021 | 0 |
Saved searches using the CDC WONDER search engine. Once you get to
the site, click on "I agree" to agree to the terms and then click on
the "Search Form" to get the results.
Deaths
Jan-Mar 2021 2046 deaths
Deaths
Apr-Jun 16, 2021 1927 deaths so far
Death
< 6 months 1 death (nursing infant died after mother's
vaccination)
Deaths
1-2 years 1 death
Deaths
6-17 years 8 dead
Deaths
18-39 years 50 dead
Deaths 30-39 years 86 dead
Deaths
40-49 years 147 dead
Deaths
50-59 years 324 dead
Deaths
60-64 years 308 dead
Deaths 65-79 years 1449 dead
Deaths
>80 years 1566 Dead