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VAERS: Adverse Events After Covid Vaccine

Id # Report Text Vax Date AE Date Age Sex Death?
909095 on 12/24/2020 the resident was sleepy and stayed in bed most of the shift.  He stated he was doing okay but requested pain medication for his legs at 250PM.  At 255AM on 12/25/2020 the resident was observed in bed lying still, pale, eyes half open and foam coming from mouth and unresponsive.  He was not breathing and with no pulse 12/23/2020 12/25/2020 66 M DIED ON 12/25/2020
910363 Patient had mild hypotension, decreased oral intake, somnolence starting 3 days after vaccination and death 5 days after administration. He did have advanced dementia and was hospice eligible based on history of aspiration pneumonia. 12/23/2020 12/26/2020 84 M DIED ON 12/28/2020
913143 Vaccine administered with no immediate adverse reaction at 11:29am. Vaccine screening questions were completed and resident was not feeling sick and temperature was 98F. At approximately 1:30pm the resident passed away. 12/29/2020 12/29/2020 84 F DIED ON 12/29/2020
913733 My grandmother died a few hours after receiving the moderna covid vaccine booster 1. While I don?t expect that the events are related, the treating hospital did not acknowledge this and I wanted to be sure a report was made. 12/29/2020 12/29/2020 85 F DIED ON 12/29/2020
914604 Spouse awoke 12/20 and found spouse dead. Client was not transferred to hospital. 12/16/2020 12/20/2020 74 M DIED ON 12/20/2020
914621 Resident in our long term care facility who received first dose of Moderna COVID-19 Vaccine on 12/22/2020, only documented side effect was mild fatigue after receiving. She passed away on 12/27/2020 of natural causes per report. Has previously been in & out of hospice care, resided in nursing home for 9+ years, elderly with dementia. Due to proximity of vaccination we felt we should report the death, even though it is not believed to be related. 12/22/2020 12/27/2020 89 F DIED ON 12/27/2020
914690 Within 24 hours of receiving the vaccine, fever and respiratory distress, and anxiety developed requiring oxygen, morphine and ativan. My Mom passed away on the evening of 12/26/2020. 12/23/2020 12/24/2020 83 F DIED ON 12/26/2020
914805 RESIDENT CODED AND EXPIRED 12/28/2020 12/29/2020 63 M DIED ON 12/29/2020
914895 Injection given on 12/28/20 - no adverse events and no issues yesterday; Death today, 12/30/20, approx.. 2am today  (unknown if related - Administrator marked as natural causes) 12/28/2020 12/30/2020 78 M DIED ON 12/30/2020
914917 Death by massive heart attack.  Pfizer-BioNTech COVID-19 Vaccine EUA 12/19/2020 12/23/2020 63 M DIED ON 12/23/2020
914961 pt passed away with an hour to hour and 1/2 of receiving vaccine.  per nursing home staff they did not expect pt to make it many more days.  pt was unresponsive in room when shot was given.  per nursing home staff pt was 14 + days post covid 12/30/2020 12/30/2020 88 F DIED ON 12/30/2020
914994 pt was a nursing home pt.  pt received first dose of covid vaccine.  pt was monitored for 15 minutes after getting shot. staff reported that pt was 15 days post covid.  Pt passed away with in 90 minutes of getting vaccine 12/30/2020 12/30/2020 90 F DIED ON 12/30/2020
915562 pt received vaccine at covid clinic on 12/30 at approximately 3:30, pt vomited 4 minutes after receiving shot--dark brown vomit, staff reported pt had vomited night before. Per staff report pt became short of breath between 6 and 7 pm that night.  Pt had DNR on file.  pt passed away at approximately  10pm.  Staff reported pt was 14 + days post covid 12/30/2020 12/30/2020 88 F DIED ON 12/30/2020
915682 Resident received vaccine per pharmacy at the facility at 5 pm.  Approximately 6:45 resident found unresponsive and EMS contacted.  Upon EMS arrival at facility, resident went into cardiac arrest, code initiated by EMS and transported to hospital.  Resident expired at hospital at approximately 8 pm 12/30/2020 12/30/2020 85 F DIED ON 12/30/2020
915880 Patient died within 12 hours of receiving the vaccine. 12/30/2020 12/30/2020 99 M DIED ON 12/31/2020
915920 Resident received vaccine in am and expired that afternoon. 12/28/2020 12/28/2020 96 F DIED ON 12/28/2020
917117 After vaccination, patient tested positive for COVID-19.  Patient was very ill and had numerous chronic health issues prior to vaccination.  Facility had a number of patients who had already tested positive for COVID-19.  Vaccination continued in an effort to prevent this patient from contracting the virus or to mitigate his risk.  This was unsuccessful and patient died. 12/22/2020 12/28/2020 82 M DIED ON 01/01/2021
917790 At the time of vaccination, there was an outbreak of residents who had already tested positive for COVID 19 at the nursing home where patient was a resident.  About a week later, patient tested positive for COVID 19.  She had a number of chronic, underlying health conditions.  The vaccine did not have enough time to prevent COVID 19.  There is no evidence that the vaccination caused patient's death.  It simply didn't have time to save her life. 12/22/2020 12/29/2020 90 F DIED ON 01/03/2021
917793 Prior to the administration of the COVID 19 vaccine, the nursing home had an outbreak of COVID-19.  Patient was vaccinated and about a week later she tested positive for COVID-19.  She had underlying thyroid and diabetes disease.  She died as a result of COVID-19 and her underlying health conditions and not as a result of the vaccine. 12/22/2020 12/29/2020 78 F DIED ON 01/02/2021
918065 1/1/2020: Residents was found unresponsive. Pronounced deceased at 6:02pm 12/30/2020 01/01/2021 64 M DIED ON 01/01/2021
918388 Resident found unresponsive without pulse, respirations at 04:30 CPR performed, expired at 04:52 by Rescue 12/30/2020 01/01/2021 65 F DIED ON 01/01/2021
918418 Resident became SOB, congested and hypoxic requiring oxygen, respiratory treatments and suctioning.  Stabilized after treatment and for the next 72 hours with oxygen saturations in the 90s.  On 1/3/2021 was found without pulse and respirations.  Resident was a DNR on Hospice. 12/30/2020 01/01/2021 65 M DIED ON 01/03/2021
918518 syncopal episode - arrested - CPR - death 12/31/2020 12/31/2020 50 F DIED ON 12/31/2020
919108 Fever, Malaise 12/22/2020 12/23/2020 100 F DIED ON 01/03/2021
919537 Resident exhibited no adverse events during 30 minute monitoring following vaccine administration. Resident found without pulse at 1900. 01/03/2021 01/03/2021 96 F DIED ON 01/03/2021
920326 Redness and warmth with edema to right side of  neck and under chin. Resident was on Hospice services  and expired on 1.1.21 12/29/2020 12/30/2020 89 F DIED ON 01/01/2021
920368 12/30/2020 07:02 AM  Resident noted to have some redness in face and respiration were fast. Resident vital signs were abnormal except blood pressure. Temp at the time was 102.0 F taken temporal. Resident respirations were 22 labored at times. Pulse is 105 and pulse ox 94% on room air. Resident is made comfortable in bed. Notified triage of change in condition also made triage aware of resident receiving Covid vaccination yesterday morning. Resident appetite and fluid consumption has been poor for few days.  12/30/2020 07:32 AM  Received order from agency to administer Acetaminophen 650mg suppos rectally due to resident not wanting to swallow anything including fluids, medications and food. This writer administered medication as NP ordered. Will monitor for effectiveness and adverse effects if any.  12/30/2020 08:41 AM  Received new orders to obtain Flu swab, obtain CBC and BMP, and Chest Xray all to be obtained today. Notified family of resident having temperature and vital signs excluding b/p that was abnormal. Family was thankful for call and inierated to nurse that family does not want resident sent to hospital. Did educate family on benefits of Hospice services, but family persistant on continued daily care provided by nursing staff. Requests visits if decline continues. Family assured if resident continues to decline, facility will accomandate resident family to be able to be at bedside when time comes to do so.  NP ordered IVF and IV Levaquin on 12/31/20. Family chose at that time to sign for Hospice services and not have resident provided with IVF or IV Antibiotics 12/29/2020 12/30/2020 92 F DIED ON 01/01/2021
920545 The resident received is vaccine around 11:00 am and tolerated it without any difficulty or immediate adverse effects. He was at therapy from 12:36 pm until 1:22 pm when he stated he was too tired and could not do anymore. The therapist took him back to his room at that time and he got into bed himself but stated his legs felt heavy. At 1:50 pm the CNA answered his call light and found he had taken himself to the bathroom. She stated that when he went to get back into the bed it was "abnormal" how he was getting into it so she assisted him. At that time he quit breathing and she called a RN into the room immediately. He was found without a pulse, respirations, or blood pressure at 1:54 pm. He was a DNR. 01/04/2021 01/04/2021 93 M DIED ON 01/04/2021
920815 Found deceased in her home, unknown cause, 6 days after vaccine. 12/30/2020 01/04/2021 58 F DIED ON 01/04/2021
920832 Vaccine 12/30/2020 Screening PCR done 12/31/2020 Symptoms 1/1/2021 COVID test result came back positive 1/2/2021 Deceased 1/4/2021 12/30/2020 01/01/2021 104 F DIED ON 01/04/2021
921175 Resident received Covid Vaccine, noted after 30 mins with labored breathing BP 161/77, HR 116, R 38, T 101.4, 01/03/2021 01/03/2021 77 F DIED ON 01/05/2021
921481 Vaccine given on 12/29/20 by Pharmacy. On 1/1/21, resident became lethargic and sluggish and developed a rash on forearms. He was a Hospice recipient and doctor and Hospice ordered no treatment, just to continue to monitor. When no improvement of codition reported, doctor and Hospice ordered comfort meds (Morphine, Ativan, Levsin). Resident expired on 1/4/2021 12/29/2020 01/01/2021 88 M DIED ON 01/04/2021
921547 DEATH ON 1/4/2021, RESIDENT RECIEVED VACCINE ON 1/2/20 01/02/2021 01/04/2021 65 M DIED ON 01/04/2021
921572 Resident had body aches, a low O2 sat  and had chills starting on 12/30/20. He had stated that they had slightly improved. On 1/1/21 he sustained a fall with a diagnosis of a displaced hip fracture. On 1/2/21 during the NOC shift his O2 sat dropped again. He later went unresponsive and passed away. 12/29/2020 12/30/2020 87 M DIED ON 01/02/2021
921667 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. 12/29/2020 01/03/2021 39 F DIED ON 01/03/2021
921768 Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived. 01/04/2021 01/04/2021 58 F DIED ON 01/04/2021
921880 The resident was found deceased a little less than 12 hours following COVID vaccination, and he had had some changes over the last 2 days.  He was 96 and had been on hospice care for a little while. Noone noticed any side effects from vaccine after it was given 01/02/2021 01/02/2021 96 M DIED ON 01/02/2021
922977 Fever, RespDepression & COVID positive REMDESIVIR (EUA) 200 mg x1 then 100 mg daily 12/21/2020 12/27/2020 71 M DIED ON 12/28/2020
923993 Patient was vaccinated Dec 30, 2020. Prime dose of Moderna vaccine. Observed for full 15 minutes post-injection. No complaints when asked during observation. Released.  Subsequently, vaccine clinic staff learned from the patient's supervisor that on Jan 4, 2021 that the patient had expired on Jan 2, 2021. By report from the supervisor, the patient was found dead at his home. The patient's primary care provider was unaware of his death when contacted by this reporter today (Jan 6, 2021). Electronic Medical Record without any information since the vaccination. 12/30/2020 01/02/2021 62 M DIED ON 01/02/2021
924126 resident expired 1/1/2021 12/30/2020 01/01/2021 84 F DIED ON 01/01/2021
924186 Resident expired 1/3/21 12/30/2020 01/03/2021 91 F DIED ON 01/03/2021
924456 Patient did not display any obvious signs or symptoms; the vaccination was administered at approximately 10:00 AM and the patient continued throughout her day without any complaints or signs of adverse reaction. Patient was helped to bed by the nursing assistant estimated at around 9:00 PM. The facility received notification from the lab around 11:00 PM that the patient's COVID-19 specimen collection from Sunday, 1/3/21, detected COVID-19. When the nursing staff went to the room to check on the resident and prepare her to move to a COVID-19 care area the patient was found unresponsive,  no movement, no chest rises, noted regurgitated small amount of food to mouth left side, lying on left side. Pupils non reactive. 01/05/2021 01/05/2021 85 F DIED ON 01/05/2021
924464 coughing up blood, significant hemoptysis -- > cardiac arrest. started day after vaccine but likely related to ongoing progression of lung cancer 01/05/2021 01/06/2021 61 F DIED ON 01/06/2021
924664 At approximately, 1855, I was alerted by caregiver, resident was not responding. Per caregiver, she was doing her rounds and found resident in bed, unresponsive, mouth open, observed gurgling noises and tongue hanging out of mouth. This primary caregiver observed resident at baseline and ambulating after dinner at approximately, 1800 less than an hour prior to incident.  This PCG called 911 for EMS and gave report of incident. Resident was taken to Medical Center Emergency Department.  At ER, CT scan and X-ray was performed.  Per report from  ER RN, CT scan and x-ray revealed an intracranial aneurysm and fluid in the lungs. Per RN, resident was still unresponsive and was admitted to Medical Center for observation and comfort measures. This primary caregiver reported to RN, resident recently received the first dose of COVID-19 vaccine on 1/2/21.  Primary caregiver received a call from Castle RN at 0700, resident expired at 0615. 01/02/2021 01/05/2021 92 F DIED ON 01/06/2021
925154 Deceased 01/03/2021 01/04/2021 84 F DIED ON 01/04/2021
925264 PT was found deceased in his home on 1/5/2021 12/31/2020 01/07/2021 77 M DIED ON 01/07/2021
925556 Expired 1/05/2021 12/30/2020 01/06/2021 81 M DIED ON 01/06/2021
926269 Pt last seen at 1200 by nurse for ID band check. No visible signs of distress noted. Pt states "I just want to be left alone". 1230 nurse was called to pt room. Pt was noted unresponsive, no pulse and respiration noted. CPR started immediately, at 1239 first shock given. 1245 EMT took over, at 1319 EMT called time of death 01/04/2021 01/05/2021 74 M DIED ON 01/05/2021
926462 Patient developed hypoxia on 1/4/2021 and did not respond to maximal treatment and passed way on 1/5/2021 12/28/2020 01/04/2021 91 M DIED ON 01/05/2021
926568 patient declined 12/30/2020 and was transferred to hospital where he did not respond to treatment and passed away 1/4/2020 12/28/2020 12/30/2020 77 M DIED ON 01/04/2021
926600 Patient did not report any signs or symptoms of adverse reaction to vaccine. Patient suffered from several comorbidities  (diabetes and renal insufficiency). Patient reported not feeling well 01/06/2021 and passed away that day. 01/04/2021 01/06/2021 65 M DIED ON 01/06/2021
926797 had a vaccination on 12/31/2020 late morning passed away early morning 01/01/2020.  This is a 93 year old with significant heart issues. EF of 20% among other comorbidities.  He died suddenly approximately 0430, it is unlikely it was related to receiving the vaccine. 12/31/2020 01/01/2021 93 M DIED ON 01/01/2021
927189 Patient was vaccinated at 11am and was found at the facility in his room deceased at approximately 3:00pm. Nurse did not have cause of death 01/07/2021 01/07/2021 74 M DIED ON 01/07/2021
927260 No adverse effects noted after vaccination.  Patient with cardiac history was found unresponsive at 16:45 on 1/6/21. Abnormal breathing patterns, eyes partially closed  SPO2 was 41%, pulseless with no cardiac sounds upon auscultation.  CPR and pulse was regained and patient was breathing.  Patient sent to Hospital ER  were she remained in an unstable condition had multiple cardiac arrest and severe bradycardia and in the end the hospital was unable to bring her back. 12/28/2020 01/06/2021 87 F DIED ON 01/06/2021
928062 vomiting later on 01/05/21.  Lethargy and hypoxia in pm of 01/06/21.  Hypotension am of 01/07/21.  Hospitalized, intubated, cardiac arrest, died 01/07/21. 01/05/2021 01/05/2021 85 M DIED ON 01/07/2021
928513 Resident passed away in her sleep 01/05/2021 01/06/2021 72 F DIED ON 01/06/2021
928933 Patient had been diagnosed with COVID-19 on Dec. 11th, 2020. Symptoms were thought to have started on 12/5/2020. Received Moderna vaccine on 12/23. Unexpected death on 1/8/2021. Resuscitation attempts unsuccessful 12/23/2020 01/08/2021 56 F DIED ON 01/08/2021
929359 3:07 pm lung sounds diminished oxygen sats 68%, oxygen applied Oxygen sats remained low for next 36 hours ( patient on Hospice care ) expired 6:22 am 1-8-21 01/06/2021 01/06/2021 76 M DIED ON 01/08/2021
929764 The patient was found deceased at home about 24 hours after immunization. Date of Death:: 12/29/2020; estimated time of death 6:00pm 12/28/2020 12/29/2020 45 M DIED ON 12/29/2020
929997 Patient received vaccine on 1/4/2021.  He was in Hospice for CHF and renal failure, but was able to get up in his wheelchair and eat and take medications and talk.  On 1/5/2021 am, he was noted to be very lethargic an could only mumble, could not swallow.  No localizing neurologic findings.  He was too lethargic to get up in chair. 01/04/2021 01/05/2021 86 M DIED ON 01/07/2021
930154 Notified today that he passed away. No other details known at this time. 01/05/2021 01/08/2021 60 M DIED ON 01/08/2021
930386 Patient received first dose of vaccine on 12/28, developed COVID-19 infection shortly thereafter and expired on 1/6/2021. 12/28/2020 01/06/2021 91 M DIED ON 01/06/2021
930418 Patient received first dose of vaccine on 12/28, developed COVID-19 infection shortly thereafter and expired on 1/4/2021 12/28/2020 01/04/2021 77 M DIED ON 01/04/2021
930431 Cardiac event, 2 days after vaccination, patient expired. 01/06/2021 01/08/2021 F DIED ON 01/08/2021
930466 Fever, shortness of breath and chest pain that resulted in a heart attack a few hours after vaccination 01/05/2021 01/05/2021 82 F DIED ON 01/05/2021
930487 Medical docter state patient has a acute cardiac attack 01/08/2021 01/08/2021 86 M DIED ON 01/08/2021
930876 Death 01/07/2021 01/08/2021 88 M DIED ON 01/08/2021
930910 Patient received COVID vaccination around 12:15pm. Patient was monitored for the appropriate amount of time by nursing staff. Patient passed away at 2:15pm. 01/08/2021 01/08/2021 52 F DIED ON 01/08/2021
930912 Diarrhea followed by death 24 hrs after vaccination 01/07/2021 01/08/2021 73 M DIED ON 01/08/2001
932346 1/7-21 - Received second dose of pfizer covid-19 vaccine 1/8/21 - Fever, dizziness, headache 1/10/21 0250 was found not breathing.  EMS performed CPR and patient deceased 01/07/2021 01/08/2021 66 M DIED ON 01/10/2021
932787 RECIEVED VACCINE 1/8/21 EXPIRED UNEXPECTED 1/10/21, NO ADVERSE REACTIONS NOTED 01/08/2021 01/10/2021 70 F DIED ON 01/10/2021
932898 The patient had an apparent cardiac arrest on 12/23/20 and was admitted to the ICU. He was taken off of life support on 12/30/20.  He had known cardiac disease. 12/17/2020 12/23/2020 61 M DIED ON 12/30/2020
933090 Patient died, I have a copy of his vaccination card 01/05/2021 01/05/2021 60 M DIED ON 01/09/2021
933739 Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and "brought back".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear. 01/08/2021 01/09/2021 54 F DIED ON 01/10/2021
933846 1-2-2021 10:30 PM Complained Right arm/back hurt - took Tylenol 1-3-2021  Complained Right arm hurt, dizzy 1-4-2021  Felt better - did laundry, daughter found her deceased at 3:30 pm.                        Dr. at hospital said it was "cardiac event" according to death certificate. 01/02/2021 01/02/2021 91 F DIED ON 01/04/2021
934050 Staff reported that patient was found Friday morning (Jan 8) sitting at a table with his head tilted forward and unresponsive to verbal or physical stimuli. Staff lowered patient to floor and started CPR. EMS was called and continued CPR at scene, however they were not able to revive patient. Patient was pronounced dead at the scene. Staff written statements following the death of patient show that he had a fall about 1 hr. prior. It is unknown if this fall contributed to patient's death. An autopsy has been requested. 01/07/2021 01/08/2021 68 M DIED ON 01/08/2021
934059 Acute anterior MI with death 01/08/2021 01/09/2021 99 F DIED ON 01/10/2021
934263 The resident resides in an independent living facility/apartment. The reporter at the center was informed by his daughter he was not feeling well on 1/1/2021 (specific symptoms could not be ascertained). He reportedly went to be COVID tested on 1/1/2020 and observed to be deceased in his apartment on 1/2/2020. I do not have confirmation of his COVID results, although the reporter indicates his daughter reports his test was positive. 12/30/2020 01/01/2021 92 M DIED ON 01/02/2021
934373 Patient went to bed around 11pm on Saturday PM and sometime between then and 1:30am on Sunday morning got up and went into the living room without waking up her husband (which is normal).  At 1:30am, the husband got up to use the restroom and she was out of bed then, but the husband did not know if she was having any problems at this time.  When he got up at 7:45am, she was in the recliner and did not move or anything, which is normal for her.  At 8:45am, the husband went back into the living room and tried to wake his wife and that is when he noticed there was no pulse and he called 9-1-1 at this time.  EMS got on scene and did CPR for 30 mins and she was pronounced dead at 9:21am. 01/09/2021 01/10/2021 82 F DIED ON 01/10/2021
934507 Resident died suddenly and expectantly on 01/05/2021 01/03/2021 01/05/2021 89 F DIED ON 01/05/2021
934539 Patient received COVID-19 (Moderna) vaccine from the Health Department on afternoon of January 8, 2021 and went to sleep approximately 2300 that night. Was found unresponsive in bed the following morning and pronounced dead at 1336 on January 9, 2021 01/08/2021 01/09/2021 68 F DIED ON 01/09/2021
934966 COVID-19; COVID-19; Pneumonia; respiratory failure; This is a spontaneous report from a contactable consumer. An 80-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on 02Jan2021 for COVID-19 immunization. Medical history included Alzheimer's and others. No known allergies. Concomitant medications included unspecified medications. The reporter's mother in law was tested for COVID-19 at a nursing facility on 25Dec2020 and she was negative. On 02Jan2021, she received the first dose of Pfizer vaccine. On 04Jan2020, she developed a high fever, needed oxygen and was positive for COVID-19. Date of death was 04Jan2021. The cause of her death was listed as pneumonia, respiratory failure and COVID-19. No autopsy performed. No treatment received. No one knew if the vaccination contributed to her death. It was hard to know if her death was due to the administration of the vaccine or it exacerbated the COVID19 symptoms which led to her death. Since this was unknown, it could have been a possibility. The reporter wanted to give us this information because we might want to consider having high risk population, patients with underlying conditions, older population tested for COVID-19 prior to the vaccination, as this is not currently a recommendation or a requirement. All is very new and they are all learning so the reporter wanted to share this information with us. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. There are medications the patient received within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The outcome of the events was fatal.   Information about Lot/Batch has been requested.; Sender's Comments: The association between the fatal event lack of effect (pneumonia, respiratory failure and COVID-19) with BNT162b2 can not be fully 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 regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: Pneumonia, respiratory failure and COVID-19; Pneumonia, respiratory failure and COVID-19; Pneumonia, respiratory failure and COVID-19; Pneumonia, respiratory failure and COVID-19 01/02/2021 01/04/2021 F DIED ON 01/04/2021
934968 he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away 01/04/2021 01/04/2021 54 M DIED ON 01/06/2021
935222 Patient was reported to be deceased at home by law enforcement on 1/7/21 12/30/2020 01/07/2021 73 M DIED ON 01/07/2021
935343 There were no adverse reactions. Resident Died, she had a history of issues with her health prior to the vaccine. 01/08/2021 01/11/2021 89 F DIED ON 01/11/2021
935350 Patient was found unresponsive at home with SpO2 20% 1/2/2021 12/31/2020 01/02/2021 81 M DIED ON 01/06/2021
935511 Patient received the 1st dose of Moderna and was found deceased in her home the next day. 01/08/2021 01/09/2021 56 F DIED ON 01/09/2021
935767 My mother was given Pfizer vaccine on Thursday and she died 3 days later yesterday on Sunday!!! 01/07/2021 01/10/2021 85 F DIED ON 01/10/2021
935815 Difficulty breathing, death. 01/05/2021 01/05/2021 63 M DIED ON 01/05/2021
936043 RESIDENT 1ST DOSE OF MODERNA VACCINE ADMINISTERED ON 01/04/2021 AT 8:30PM, RESIDENT FOUND UNRESPONSIVE ON 01/05/2021. 01/04/2021 01/05/2021 98 F DIED ON 01/05/2021
936738 loss of consciousness Narrative:  Patient received COVID-19 vaccine dose #1 on 1/6/21 w/o complications. Per 1/6/21- 1/9/21 nursing notes, patient did not experience any injection site reactions, denied pain or tenderness at injection site, no dizziness, no n/v, remained afebrile. Around 1/9/21 @1810, patient became acutely nonresponsive after being helped to the edge of bed. Per nurses, he was previously awake/alert, talking and asymptomatic. Patient is DNR/DNI but facility rapid response emergency team called d/t patient's sudden change of condition. Emergency team helped patient into lying position. Per 1/9/21 ICU emergency team note, patient appeared comfortable w/ no palpable radial pulse and had minimal shallow agonal breathing. Pulse ox 94%, HR in 60s per machine. BP unmeasurably low by BP cuffx3. Resident passed at 18:20 pm. 01/06/2021 01/09/2021 89 M DIED ON 01/09/2021
936805 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. 12/22/2020 01/11/2021 25 M DIED ON 01/11/2021
937127 The facility had positive cases of COVID when we were able to begin vaccinating residents.  Within about a week of vaccination, patient was tested positive for COVID.  He was 91 years old and his immune system did not have the time to allow the vaccine to begin working before exposure.  His age was a major contributing factor to his death. 12/22/2020 12/28/2020 91 M DIED ON 01/04/2021
937152 The facility had positive cases for COVID 19 when the vaccine was received and administered to patient.  With her advanced age and chronic conditions, she did not have time to build immunity between the time of vaccination and her testing positive. 12/22/2020 12/24/2020 91 F DIED ON 01/11/2021
937186 The facility had a number of positive COVID 19 cases prior to patients vaccination.  Due to her advanced age, chronic condition, and exposure, patient did not have the time to build immunity after exposure before becoming positive. 12/22/2020 12/24/2020 87 F DIED ON 01/10/2021
937434 Pt expired due to possible cardiac arrest.  Unsure if this was vaccine related. 01/07/2021 01/11/2021 70 M DIED ON 01/12/2021
937444 Resident was found deceased at approximately 6pm in her apartment 01/11/2021 01/11/2021 86 F DIED ON 01/11/2021
937527 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. 12/23/2020 01/04/2021 44 F DIED ON 01/04/2021
937569 patient reported expired 1/7/2021 01/02/2021 01/07/2021 62 M DIED ON 01/07/2021
937773 Patient was sent to the ED due to significant hematuria. He was afebrile. 01/02/2021 01/02/2021 85 M DIED ON 01/03/2021
938118 on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm 01/05/2021 01/08/2021 51 F DIED ON 01/10/2021
938974 Hospice Resident received first Covid 19 vaccine dose on 1/6/21.  1/7/21 resident had decreased appetite noted in am but ate 100% of meal at dinner.  1/9/21 resident had decreased appetite with emesis x 2, loose BM x 2.  Call placed to hospice.  1/10/21 5:44 am resident able to take HS meds, ingest 2 cups of shake.  No emesis or loose stool noted.  12PM nurse noted resident not eating meals but ingesting milkshake and medications without any problems.  Hospice contacted for change in condition.  1:00 pm hospice ordered Phenergan 12.5 mg Q 6 hrs PRN.  Labs to be drawn 1/11/21. Hospice notified POA.  1/11/21 12:24am Resident had blood in stool. Resident denies any pain, on 2L of O2 for comfort. 01/06/2021 01/11/2021 88 M DIED ON 01/11/2021
939050 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. 12/28/2020 12/29/2020 32 F DIED ON 01/04/2021
939270 Sudden cardiac death 12/22/2020 12/31/2020 48 M DIED ON 12/31/2020
939845 Three hours after receiving COVID 19 vaccination, Patient oxygen level decreased to a  critical level and went into cardiac arrest. Staff performed full code but was unable to bring back patient from  cardiac arrest. 01/11/2021 01/11/2021 88 M DIED ON 01/11/2021
940822 patient passed away after receiving the Covid vaccine; This is a spontaneous report from a contactable nurse.  An 81-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), intramuscular  into the right arm on 07Jan2021 at 0.3 mL, single for covid-19 immunization.  There was no medical history and no concomitant medications.  On 08Jan2021, the patient passed away after receiving the COVID vaccine.  The patient died on 08Jan2021.  An autopsy was not performed. Investigations indicate that unspecified labs were done, but nothing two weeks prior; no further details were provided. The patient received the first dose the day prior. The reporting nurse discussed it with the medical director, and he thought that he potentially passed away from the COVID vaccine. The relatedness of the event to the suspect vaccine was reported as related by the reporting nurse per The Agency.  The batch/lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up .; Sender's Comments: Based on the limited information available, it is medically not possible to make meaningful causality assessment, it is unlikely the vaccine could have contributed to the death of the patient based on the known safety profile. However case will be reevaluated when additional information is received during the follow-up  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: Stated that the patient passed away after receiving the Covid vaccine 01/07/2021 01/08/2021 81 M DIED ON 01/08/2021
940855 Patient received her vaccination on 1/12/21 administered by pharmacy*+. She expired on 1/12/21 an approximately 7:30pm. Resident did not have any adverse reactions and was a hospice patient. 01/12/2021 01/12/2021 79 F DIED ON 01/12/2021
940866 Patient was found "acting abnormal" on 1/9/2021 at 1215. VS HR 20-30's. EMS activated. EMS arrived and patient was found pulseless in PEA/ asystole,  CPR and ACLS initiated and then transported to the MC. Unsuccessful resuscitation  and expired on 1/09/2021 at 1348. Clinical impression Cardiopulmonary arrest. 01/07/2021 01/09/2021 75 M DIED ON 01/09/2021
940954 Heart attack; This is a spontaneous report from a contactable consumer. An 82-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: and Expiration Date: Unknown), via an unspecified route of administration in the left arm on 05Jan2021 at 13:00 at a single dose for COVID-19 immunization; administered in doctor's office/urgent care.  The patient's medical history and concomitant medications were not reported. It was unknown if the patient received any other vaccines within four weeks prior to the COVID vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 05Jan2021, the patient experienced heart attack; which resulted in death and was assessed as medically significant. The patient also experienced the associated symptoms of cold sweats, chest pain, shortness of breath. Therapeutic measures were taken as a result of heart attack, which included "life saving measures" by the paramedics performed upon arrival with no success. The clinical outcome of the event, heart attack, was fatal. The patient died on 05Jan2021 due to heart attack; as ruled by the paramedics. It was unknown if an autopsy was performed.  The batch/lot numbers for the vaccine, PFIZER-BIONTECH COVID-19 MRNA VACCINE, were not provided and will be requested during follow up.; Reported Cause(s) of Death: Heart attack 01/05/2021 01/05/2021 82 F DIED ON 01/05/2021
940955 Cardiac Arrest; Patient was found pulseless and breathless 20 minutes following the vaccine administration.; Patient was found pulseless and breathless 20 minutes following the vaccine administration.; This is a spontaneous report from a contactable other healthcare professional (HCP). A 66-year-old female patient (pregnant at the time of vaccination: no) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL1284) via intramuscular at left arm on 11Jan2021 12:15 PM at single dose for COVID-19 immunization. Medical history included diastolic CHF, spinal stenosis, morbid obesity, epilepsy, pulmonary hypertension and COVID-19 (Prior to vaccination, the patient was diagnosed with COVID-19). The patient received medication within 2 weeks of vaccination included amiodarone, melatonin, venlafaxine hydrochloride (EFFEXOR), ibuprofen, aripiprazole (ABILIFY), lisinopril, cranberry capsules, diltiazem, paracetamol (TYLENOL), famotidine, furosemide (LASIX [FUROSEMIDE]), ipratropium bromide, salbutamol sulfate (IPRATROPIUM/ALBUTEROL), buspirone, senna alexandrina leaf (SENNA [SENNA ALEXANDRINA LEAF]), polyethylene glycol 3350 and morphine. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient used took Penicillin, propranolol, quetiapine, topiramate, Lamictal and had allergy to them. Patient used took the first dose of BNT162B2 (lot number: EJ1685) via intramuscular at right arm on 21Dec2020 12:00 PM at single dose for COVID-19 immunization. Since the vaccination, the patient been tested for COVID-19 (Sars-cov-2 PCR) via nasal swab on 06Jan2021, covid test result was negative. Patient was found pulseless and breathless 20 minutes following the vaccine administration (11Jan2021 12:30 AM). MD found no signs of anaphylaxis. Patient died on 11Jan2021 12:30 AM because of cardiac arrest. No treatment received for the events. Outcome of pulseless and breathless was unknown. the autopsy was performed, and autopsy remarks was unknown. Autopsy-determined cause of death was unknown.  It was reported as non-serious, not results in death, Life threatening, caused/prolonged hospitalization, disabling/Incapacitating nor congenital anomaly/birth defect.; Sender's Comments: Based on the available information this patient had multiple underlying medical conditions including morbid obesity, diastolic CHF, epilepsy, pulmonary hypertension and COVID-19 diagnosed prior to vaccination. All these conditions more likely contributed to patients cardiac arrest resulting in death. However, based on a close temporal association ("Patient was found pulseless and breathless 20 minutes following the second dose of BNT162B2 vaccine administration, contributory role of BNT162B2 vaccine to the onset of 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 Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Cardiac arrest; Autopsy-determined Cause(s) of Death: autopsy remarks was unknown. Autopsy-determined cause of death was unknown 01/11/2021 01/11/2021 66 F DIED ON 01/11/2021
941215 Actual event and cause of death were unknown; This is a spontaneous report from a non-contactable consumer. A 90-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06Jan2021 at single dose for COVID Prevention. The relevant medical history included aortic valve replacement from Nov2019. Concomitant medications were not reported. The consumer stated that she was taking the reporting responsibilities to report that a friend of hers, informed that the patient passed away on Friday, and had received the COVID vaccine on Wednesday. The consumer stated that it was unknown to her at this time, if the friend had called to complete a report herself, regarding the incident. Their conversation was very brief. The patient was 90 years old, and it was her friend's mother that was the patient. Actual event and cause of death were unknown. The patient had her vaccine on Wednesday 06Jan2021, and then the patient collapsed in front of the reporter at Friday night on 08Jan2021 and passed away that same day. The autopsy was unknown. The outcome of the event was fatal.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Actual event and cause of death were unknown 01/06/2021 01/08/2021 90 F DIED ON 01/08/2021
941561 Staff walked into resident's room around 10:00am and noted resident's left side of his face was flaccid. Nurse was called and upon assessment resident noted to have an unequal hand grasp with left worse. He was able to talk but was mumbled and hard to understand. Physician, hospice, and family were notified. Resident had a stroke at 10:06 am on 1/8/2020. He lost all ability to use his left side. Resident passed away on  1/11/2020. 01/07/2021 01/08/2021 91 M DIED ON 01/11/2021
941607 The patient passed away today, 1/13/2021.  She was a hospice patient.  She showed no adverse effects after receiving the vaccine on 1/12/2021. This morning she woke up as normal and during her morning shower she had a bowel movement, went limp and was non-responsive.  The patient passed away at 7:45 am. 01/12/2021 01/13/2021 83 F DIED ON 01/13/2021
941743 This person was found to be deceased on routine rounds during the night, 3am. No symptoms of reaction noted post vaccine. No injection site reaction. No reports of any allergic reaction. 01/12/2021 01/13/2021 60 F DIED ON 01/13/2021
942040 little bit of a reaction light headed after 5 minutes.   vitals were low, so observed for 30 minutes after being light headed.  Patient was found unresponsive and pronounced dead later that day. 01/13/2021 01/13/2021 78 M DIED ON 01/13/2021
942072 Death occurred 3 days after vaccine receipt; attributed to complications of her chronic advanced dementia with aspiration at age 87. No evidence of acute vaccine reaction. 01/02/2021 01/05/2021 87 F DIED ON 01/05/2021
942085 No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found. 01/02/2021 01/08/2021 62 F DIED ON 01/08/2021
942106 54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day. 01/08/2021 01/09/2021 54 M DIED ON 01/09/2021
942290 Resident received 1st dose on 1/4/2021. On 1/6/2021 resident having SOB, increased weakness with O2 sats at 91% RA. On 8th resident sustained a fall, O2 sats 88-92, dizzy, weakness.  Rapid COVID test performed with negative results.  Evening of 8th resident was lethargic and diaphoretic with fever of 99.9.  Resident transferred to ER, on 5lt of oxygen.  Resident returned from the ER on 1/9/2021 with new diagnosis of Leukemia and orders for hospice.  Continued with fever, crackles and N/V and loss of appetite from the 9th and 10th of January.  Resident expired at 820am on 1/11/2021. 01/04/2021 01/06/2021 89 F DIED ON 01/11/2021
943266 Initial pain in back of head and extreme headache. Some vomiting.  At emergency, went into coma and was intubated.  Hole drilled in skull to relieve pressure.  MRI taken.  Lot of bleeding in brain - anuerism lead to death approximately 14 hours after initial symptoms. 01/12/2021 01/12/2021 88 F DIED ON 01/13/2021
943362 Pt collapsed at home approx 5:30 pm and died 01/13/2021 01/13/2021 73 F DIED ON 01/13/2021
943397 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. 12/23/2020 01/11/2021 28 M DIED ON 01/11/2021
944282 resident coded on 09Jan at 8am and expired; This is a spontaneous report from a contactable Other Health Professional. A 70-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EL0140), intramuscularly in left arm on 05Jan2021 15:15 at single dose for COVID-19 immunization. Medical history included DM2(Type two diabetes mellitus), CHF(congestive heart failure), open wound, wound infection, heart failure. Allergies to medications, food, or other products: none. Concomitant medications included unspecified products (List of any other medications the patient received within 2 weeks of vaccination: yes). If the patient received any other vaccines within 4 weeks prior to the COVID vaccine: Unknown. Facility where the most recent COVID-19 vaccine was administered: Nursing Home/Senior Living Facility. The resident coded on 09Jan2021 at 8 AM and expired. The patient died on 09Jan2021. An autopsy was not performed. AE resulted in: patient died. Death cause: unknown at this time. Was treatment received for the adverse event: Unknown. Prior to vaccination, was the patient diagnosed with COVID-19: No. Since the vaccination, has the patient been tested for COVID-19: No. Serious: Yes. Seriousness criteria-Results in death: Yes. Seriousness criteria-Life threatening: No. Seriousness criteria-Caused/prolonged hospitalization: No. Seriousness criteria-Disabling/Incapacitating: No. Seriousness criteria-Congenital anomaly/birth defect: No.; Sender's Comments: The old patient had diabetes mellitus, congestive heart failure, open wound complicated by infection, all these pre-existing medical conditions contribute to the patient death.  More information including complete medical history, concomitant medications and event term details especially death cause and autopsy results are needed for a full assessment of the case.  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: resident coded on 09Jan at 8am and expired 01/05/2021 01/09/2021 70 M DIED ON 01/09/2021
944365 Resident expired on 12/30/20, dx cardiac arrest. 12/26/2020 12/30/2020 76 M DIED ON 12/30/2020
944439 Resident expired on 1/2/21. 12/26/2020 01/03/2021 62 F DIED ON 01/03/2021
944595 Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later 01/12/2021 01/12/2021 56 M DIED ON 01/14/2021
944641 Patient died on 1/21-2021 01/12/2021 01/13/2021 83 F DIED ON 01/13/2021
944732 Resident found unresponsive and without pulse at 05:45am. 01/13/2021 01/14/2021 92 M DIED ON 01/14/2021
944998 On 1/11/21  noted with headache, nausea/vomiting, severe melaise.  On 1/12/21 resident expired. 01/04/2021 01/12/2021 88 F DIED ON 01/12/2021
945241 71yo female resident who died after receiving Pfizer BioNTech vaccine.  On 1/14/2021, VS taken at 10am, B/P 99/60, O2 sats, 95% (trach w/O2). At 11:30am, Patient showed no s/sx of distress, A&Ox3.  At 11:50am, a nurse went to perform a COVID test and assessment (the facility is experiencing an outbreak), and found the patient unresponsive on the bathroom floor.  CPR was immediately started; no shock advised per AED; 12:15pm EMS arrived and took over.  At 12:38pm, EMT called time of death. 01/13/2021 01/14/2021 71 F DIED ON 01/14/2021
945247 Has underlying dementia and often with difficulty eating.  1 week after immunization she developed a stroke with left sided weakness and difficulty swallowing.  Comfort measures instituted.  Not sure if this is related to the vaccine, but thought I should report 12/29/2020 01/05/2021 96 F DIED ON 01/13/2021
945253 83yo female resident who died after receiving Pfizer BioNTech vaccine.  On 1/14/2021, the patient reportedly got up in the middle of the night with c/o feeling "blah", restlessness, and nausea.  VS normal, no other s/sx. At 4:15am,  the patient was asked to go back to bed, assisted by a nurse and GNA.  At 6am, GNA was going to do morning VS and found the patient unresponsive, no pulse, no respirations.  GNA notified the nurse. At 6:03am, CPR started and EMS called.  At 6:15am, EMS arrived and took over.  At or around 6:30am, EMT called time of death 01/13/2021 01/14/2021 83 F DIED ON 01/14/2021
945578 No reactions immediately after vaccine was given. Resident has dementia, has had multiple hospitalizations related to a renal stone recently. Had a tooth that was bothering her, went to see her dentist and it was extracted on 1/6/21. On 1/10 they noted feet and ankles are dark purple with white splotches appears to be mottling. Minimally responsive to voice and touch. Not eating. Compassionate visit with family. Family did not want hospice, did not feel it was needed, said, what more could they do for her than you're already doing?  On 1/11 at 1950 was determined to be deceased. 01/02/2021 01/10/2021 72 F DIED ON 01/11/2021
945603 Had no immediate issues with the vaccine. He had returned from the hospital on 12/21 and had some concerns about his weight which were shared with his physician on 1/4/21. On 1/5/21 had a visit with his cardiologist for a pacemaker check. On 1/8/21 staff were called to his room, he was on the floor, bluish skin color. No vital signs found, no heart rhythm heard at 2200. 01/02/2021 01/08/2021 94 M DIED ON 01/08/2021
946225 At approximately 10:30pm on 1/14/2021, resident was noted to have a rash on her face, hands, arms, and chest. VS:100.2, 113, 20,108/59, 84% room air. applied nasal cannula at 4-L, telephoned Physician orders 6mg Decadron one time order, a second set of Vitals , reads 99.3, 110, 20, 106/60, 90% on 4-L N/C. On coming shift advised. At approximately 2:00am on 1/15/2021, resident congested and coughing. BP 151/70, pulse 124, temp 98.1 forehead, resp 20 and pulse oc 79% on 3L. At approximately 2:30am PRN cough syrup and breathing tx. Resident's condition began to worsen with breathing tx. This LPN updated at 0248 doctor on resident's condition. Doctor gave permission for resident to go to hospital. At 4:19am the Er called to say resident passed away. 01/14/2021 01/14/2021 70 F DIED ON 01/15/2021
946293 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. 01/07/2021 01/07/2021 51 M DIED ON 01/12/2021
946959 Sudden death 18 hours post vaccine . 01/14/2021 01/15/2021 83 M DIED ON 01/15/2021
947129 Resident received Moderna vaccine on 12/23/2020 around 5 pm.  At approximately 3:35 am on 12/25/2020, resident had a CVA and died on 1/1/2021 at 3:00 am. 12/23/2020 12/25/2020 101 F DIED ON 01/01/2021
947642 died two days after receiving the vaccine; Fever; This is a spontaneous report from a contactable consumer (patient's stepchild). A 66-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, on 07Jan2021 (at the age of 66-years-old) as a single dose for COVID-19 immunization. The patient's medical history was not reported. Concomitant medications included an unspecified statin. The patient experienced fever on 08Jan2021. The patient died two days after receiving the vaccine on 09Jan2021, which was reported as fatal. The clinical course was reported as follows: The patient had a fever the day after getting the vaccine and then he just died in the middle of night. It was reported that it was not clear what exactly happened, but they are looking into this. The clinical outcome of fever was unknown and of died two days after receiving the vaccine was fatal. The patient died on 09Jan2021. The cause of death was not reported.  An autopsy was not performed (was reported to be taking place soon).  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: died two days after receiving the vaccine 01/07/2021 01/08/2021 66 M DIED ON 01/09/2021
947662 Accelerated decline in condition with decreased input, decreased responsiveness, somnolence, and death 12/30/2020 01/01/2021 84 M DIED ON 01/06/2021
947841 Patient had no immediate effects from the vaccine, but died approximately 8 hours after receiving first dose of vaccine. 01/14/2021 01/14/2021 83 M DIED ON 01/14/2021
947974 Resident was found without a pulse and not breathing 20 minutes after vaccine administration. Upon MD review, no signs of anaphylaxis were noted. 01/11/2021 01/11/2021 66 F DIED ON 01/11/2021
948150 increase weakness and fatigue, weakness in extremities, incontinent, jerky arm movements, within first 24 hours, continue to decline sent to hospital returned weaker, within 24 hrs hours BP dropped, low pulse  oximeter reading, diaphoretic, lung sounds diminished, loss consciousness and passed away. 01-12-2021 01/08/2021 01/09/2021 84 M DIED ON 01/12/2021
948164 Abdominal pain, Headaches, chest pain, loss of appetite, confusion, elevated liver enzymes 1/8-1/15/21 01/06/2021 01/08/2021 77 M DIED ON 01/15/2021
948228 Patient reportedly expired the day following receipt of the vaccine. 01/12/2021 01/13/2021 78 M DIED ON 01/13/2021
948418 Expired on 1/12/2021; unknown cause of death 01/07/2021 01/12/2021 37 F DIED ON 01/12/2021
949474 Resident had lunch on 01/14/21 and after lunch around 2:00pm, he vomited and stopped breathing. We coded the resident and 911 paramedics came. They pronounced him dead at 2:18pm. 01/13/2021 01/14/2021 79 M DIED ON 01/14/2021
949523 Around 00:50am on 01/15/21, C.N.A. reported that the resident looked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced resident dead at 1:01 am. 01/13/2021 01/15/2021 61 F DIED ON 01/15/2021
949547 The patient stated " I just feel Blah". vital signs obtained. 156/75 p-84 spo2 94% via NC 2L. T-96.7, c/o feeling restless, c/o nausea with no vomiting. Patient observed at 0600 nonresponsive, CPR initiated, and EMS notified  Patient expired 01/13/2021 01/14/2021 83 F DIED ON 01/14/2021
949630 This patient has been under hospice care for over 2 years at the nursing home. She has had a steady decline with gradual weight loss. She was totally dependent in her care needs. She received the vaccine on 1/2/2021 as part of the facility vaccination campaign. No adverse events noted initially. On 1/3/2021 at 6:06 pm, she was noted on vital sign checks (done every 4 hours for first 72 hours after vaccination) with BP 64/52 but otherwise asymptomatic. Subsequent BP improved. On 1/4/2021 at 4:45 am, pt found with respiratory rate of 30 with otherwise normal vital signs. Tachypnea persisted, so she received liquid morphine 2.5 mg without improvement. Supplemental oxygen was applied. Tachypnea persisted. She had poor oral intake after that point had persistent tachypnea and worsening hypoxemia despite clear lungs on exam. She remained under hospice care and comfort measures were continued. No blood testing or imaging tests were done. She required increasing amounts of oxygen, became hypotensive, and died peacefully on 1/8/2021 at 7:45 pm. 01/02/2021 01/03/2021 98 F DIED ON 01/08/2021
949657 Veteran was found by family slumped over and unresponsive  at the breakfast table  on 1/13/21,  had expired 01/12/2021 01/13/2021 89 M DIED ON 01/13/2021
949965 Patient 101 years old, nursing home resident, received vaccine 1/11, on 1/13 found on floor without obvious trauma, unresponsive.  Brought to ED and was bradycardic, hypotensive, hypothermic and refractory to aggressive medical management.  No obvious cause of death found on exam or labs, cxr.  Unknown if event could be related to vaccine or not.  Medical Examiner accepted case although initially unknown that patient had recently received vaccine. ME updated with that information today as soon as discovered. 01/11/2021 01/13/2021 101 F DIED ON 01/13/2021
950057 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 01/15/2021 01/15/2021 49 F DIED ON 01/15/2021
950073 On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating "I don't care." repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21. 01/15/2021 01/15/2021 63 M DIED ON 01/16/2021
950108 "Moderna COVID-19 Vaccine EUA" It has been reported to me that pt. had gone into hospital for a heart catheterization on 1/12/2021.  It was found during this procedure that pt. had suffered a MI.  She was release to home the following day and passed away at her residence on 1/15/2021. 01/05/2021 01/12/2021 53 F DIED ON 01/15/2021
950441 Pt had witnessed arrest by wife. Pt wife started CPR and called EMS. CPR started at 15:12. Continued by EMS. Pt arrived to medical center asystole with CRP in progress and ventilated via igel device.  He was in refractory ventricular fibrillation and continued CPR for a total of 1 hour.  At that point, we checked a bedside ultrasound which showed his heart at a standstill.  He was unresponsive to verbal and tactile stimulus and had fixed unreactive pupils.  He was pronounced at 16:13. 01/15/2021 01/15/2021 66 M DIED ON 01/15/2021
950893 Death 01/03/2021 01/07/2021 90 F DIED ON 01/07/2021
950935 Resident expired 01/12/2021 01/15/2021 F DIED ON 01/15/2021
950979 Headache after dose was given at 10:00 a.m   Died at after 7:30 pm the same night the dose was given. 01/14/2021 01/14/2021 81 M DIED ON 01/14/2021
951101 PATIENT GOT HER FIRST COVID PFIZER VACCINE AT 12/31 IN THE AM. HAD GOTTEN FLU LIKE SYMPTOMS AND HAD BEEN SICK FOR A COUPLE OF DAYS. HAD NAUSEA AND VOMITTING DURING THIS TIME AS WELL. ON 1/3 THE CARE GIVER WENT TO CHECK ON HER PT AT HER LTC FACILITY WHERE SHE LIVES AND SHE WASN'T ACTING RIGHT. SHE WAS UNABLE TO DO A STROKE EXAM. PT HAD NO MOVEMNET IN ARMS OR LEGS AND WAS UNABLE TO SPEAK. PT WAS VITALLY STABLE AT THE TIME. EMS RECORDED THAT THEY THOUGHT DIAGNOSIS WOULD BE STROKE, PNEUMONIA OR SEPSIS. AFTER ARRIVAL AT THE HOSPITIAL DETERMED THAT SHE HAD A STORKE, ACUTE KIDNEY INJURY, ABNORMAL LFTS. 12/31/2020 01/03/2021 90 M DIED ON 01/05/2021
951518 Narrative: Patient with severe aphasia and only able to say "hey, hey, hey" or "uh huh" or shake his head no as a way to communicate. Patient previously able to ambulate with significant limp and hyperextension of right knee, but mostly wheelchair bound over last several years as he had had a slow and steady decline in overall health and mobility. Patient developed aggressive behavior of shouting "hey" and grabbing of groin in 2016. This was worked up with CT scans, labs, referral to urology, neurology, and referrals to psychiatry. The exact etiology of this action was never able to be affirmed, but thought to be more psychiatrically related. It improved significantly with addition of antipsychotics, worsened when antipsychotics were reduced, and improved again with addition of injectable antipsychotic on 12-10-2020.Patient suffered from falls on occasion given his significantly impaired physical mobility. His last documented fall was 8-31-2019. Patient began utilizing wheelchair most of time following that fall. No significant injuries noted in documentation of the falls. In the last 3 months, patient would often refuse medications. He would sometimes indicate that they would cause dizziness, and other times he would simply refuse. We attempted to hide medications in his food/fluid (with wife's blessing) and when he detected this he would occasionally refuse to eat. Patient previously on DOAC. After pharmacy review in 12/2020 it was recommended to discontinue this as no clear indication to continue use. He was high fall risk and would often refuse this medication as well since 10/2020. Noted to be in NSR on EKGs and decision made to discontinue the DOAC. Patient had no evidence of adverse effects noted after vaccination on December 28th. Patient seen by provider on the morning of his death (1/4/2021) with no noticeable significant change in health condition. Temperature 36.8Con January 4th at 19:45. During routine bedtime cares, patient suddenly collapsed and death was pronounced January 4, 2021 at 20:05. Autopsy was requested from next of kin and no autopsy was granted. Symptoms: & DEATH Treatment: 12/28/2020 01/04/2021 77 M DIED ON 01/04/2021
951519 Narrative: Symptoms: Palpitations & Syncope Treatment: EPINEPHRINE 1 MG ONCE ,EPINEPHRINE 1 MG ONCE ,SODIUM BICARBONATE 50 ML ONCE 01/05/2021 01/05/2021 78 M DIED ON 01/05/2021
951678 Heart attack death medical test 01/13/2021 01/17/1921 75 M DIED ON 01/17/2021
951688 Resident expired 1/17/21 01/02/2021 01/17/2021 63 M DIED ON 01/17/2021
952204 Patient became sick 3 hours after the vaccine and was found deceased 1 day after his vaccination. He passed away in his sleep. 12/30/2020 12/30/2020 75 M DIED ON 12/01/2020
952704 Daughter call in for VAERS report to file for father whom committed suicide 1/16/2021 in the AM after reportable ae of COVID 19 vaccine administered 1/14/2021.  Patient sought care twice at  ER; first visit by ambulance around 5PM and Friday 1/15/2021 Medical Center: Emergency Room.  1st Discharge summary diagnosis: adverse reaction to COVID shot; 2nd Discharge summary diagnosis: adverse reaction to COVID shot, fever, Panic Disorder-- ER. Medical Center Discharge summary diagnosis: Adverse reaction to the vaccine, acute anxiety. Reportable patient symptoms at, 1st visit : fever, shaking stomach cramps, breathing issues.  Medical Center  -- No fever, confusion and dementia type, patient would not stay in patient bed; patient would get up and sit down again repeatedly, agitated and anxious. Attempted to urinated hospital bed.  Patient committed suicide in home. 01/14/2021 01/14/2021 79 M DIED ON 01/16/2021
952713 Weakness, Low O2, death. Positive for COVID on 1/12/21, dies on 1/16/21 12/30/2020 01/12/2021 64 M DIED ON 01/16/2021
952799 On 1/17/2021 at 4:35 am resident found apneic and pulseless, at 4:40am death confirmed 01/05/2021 01/17/2021 79 M DIED ON 01/17/2021
952881 Resident was seen by MD on 1/11/2021 due to increasing in edema and shortness of breath. Lasix 40 mg STAT given. New orders to get a STAT CBC, CMP, and BNP. Resident has been dependent on Oxygen since his diagnosis of COVID-19 on 11/23/2020. Labs were abnormal. Continued on the lasix 40 mgs. Resident remained short of breath with exertion and on oxygen. He was assisted to the toilet on 1/15/2021 in the morning where he subsequently passed away. 01/10/2021 01/11/2021 89 M DIED ON 01/15/2021
953129 Patient presented to our Emergency Department via EMS in full code status; asystole.  Patient expired. Per nursing, husband stated patient awoke this AM and reported pain in back between shoulders and in bilateral shoulders. Patient then went unresponsive and husband called EMS. 01/09/2021 01/18/2021 74 F DIED ON 01/18/2021
953183 1/11/21 at 8:57 Resident with fever and at 11 am saturation down to 83  O2  to 10 liters.  Resident continued to decline until CTB on 1/14/2021 at 1325 01/05/2021 01/11/2021 83 M DIED ON 01/14/2021
953348 Patient was living in a nursing home with positive cases when administered.  His age and chronic condition was such that he did not have time after the vaccination to avoid exposure or develop immunity. 12/22/2020 12/24/2020 81 M DIED ON 01/14/2021
953590 resident expired; This is a spontaneous report from a contactable healthcare professional.  An 82-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: EL0140), intramuscular in the left arm on 05Jan2021 15:00 at a single dose for COVID-19 immunization.  Medical history included metabolic encephalopathy from, failure to thrive (FTT), diabetes mellitus (DM) 2 , chronic obstructive pulmonary disease (COPD), arthritis, weakness, hyperlipidemia, chronic kidney disease (CKD), dementia.  Known allergies was none.  The patient took unspecified concomitant medication.  On 11Jan2021, the resident expired.  The patient underwent lab tests and procedures which included nasal swab: negative on 09Jan2021.  There was no treatment given for the event. The patient died on 11Jan2021.  An autopsy was not performed.; Sender's Comments: Lacking information on the cause of patient's demise, the Company cannot completely exclude a causal relationship between COVID 19 vaccine, BNT162B2, and patient's death of unknown cause, as a cautionary measure and for reporting purposes. The patient's pre-existing medical condition of metabolic encephalopathy from, failure to thrive (FTT), diabetes mellitus (DM) 2 , chronic obstructive pulmonary disease (COPD), arthritis, weakness, hyperlipidemia, chronic kidney disease (CKD), dementia may have provided the contribution to the event in this 82-year-old male patient.  The impacts of this report on the benefit/risk profile of the 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: resident expired 01/05/2021 01/11/2021 82 M DIED ON 01/11/2021
953754 patient suddenly developed pneumonia 7 days after vaccination and died the evening of developing pneumonia 01/06/2021 01/13/2021 74 F DIED ON 01/13/2021
953785 Death 01/07/2021 01/16/2021 73 F DIED ON 01/16/2021
953858 patient started to decline 1/10/2021, patient seen at facility by medical professional - patient deceased 1/13/2021 01/08/2021 01/13/2021 76 F DIED ON 01/13/2021
953865 REPORTING ONLY AS RESIDENT EXPIRED ON 1/17/2021 3 DAYS AFTER. S/S HYPOXIA/CONGESTED LUNG SOUNDS 01/14/2021 01/17/2021 99 M DIED ON 01/17/2021
953922 The day following the vaccine, the patient complained of throat issues and anxiety.  This was not new... however .  That evening he reported difficulty breathing and was placed on oxygen; a COVID test was performed and was negative.   On 12/30/2020, patient complained of sternal pressure and was transferred to the hospital.  The patient died 12/31/2020 and records obtained from the hospital indicated the patient died from a massive myocardial infarction. 12/26/2020 12/27/2020 72 M DIED ON 12/31/2020
954251 71 year old woman at rehabilitation center for physical therapy with history of cirrhosis of the liver, asthma, and heart condition was tested for COVID-19 on 01/07/21, received 1st dose of Pfizer COVID-19 vaccine on 01/08/21, positive test result for COVID-19 received on 01/09/21.  She was sent to the hospital and admitted  on 01/12/21 after O2 was 70% and was in a confused state.   Patient passed away on 01/17/21. 01/08/2021 01/12/2021 71 F DIED ON 01/17/2021
954780 On 1/13/2021,  resident had sudden emesis. Immediately following emesis he was noted without a pulse and pronounced deceased. No acute symptoms noted prior to this episode. Resident does have a significant cardiac history. 01/05/2021 01/13/2021 82 M DIED ON 01/13/2021
954812 She had the first dose of Pfizer vaccine at the Campus on Friday 1/15 at 4:30 pm. After the vaccine, she had no new symptoms or signs of vaccine reaction and MD friend reports that he checked her pulse which was not elevated from baseline. On 1/16,  she awakened and continued to feel at her recent baseline. However, in the early afternoon, she complained of  headache, nausea/epigastric pain, and chest heaviness. These apparently were not unusual symptoms for her to feel intermittently.  Per her niece, who has a home O2 sat device, her 02 sat that morning was 97 with a HR of 87 irregularly irregular. She was afebrile. (continue on page 2) 01/15/2021 01/16/2021 86 F DIED ON 01/16/2021
955261 Death 01/18/2021 01/19/2021 85 F DIED ON 01/19/2021
955390 Resident received vaccination on January 15, 2021.  She was found unresponsive with shallow respirations on the morning of January 16, 2021 and was sent to ER via ambulance.  The resident was admitted to medical center ICU where she passed away later that day. 01/15/2021 01/16/2021 95 F DIED ON 01/16/2021
955425 resident had a pressure ulcer to RT hip, was getting treatment on. Was scheduled to have wound debrided and wound vac applied on 1-19-2021. Appetite was poor, not wanting to get out of bed, and decline in alertness. Passed away on 1-16-2021 01/05/2021 01/15/2021 90 M DIED ON 01/16/2021
955436 patient received vaccine 12/29. Unexpected death 1/5. 12/29/2020 01/05/2021 84 M DIED ON 01/05/2021
955532 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. 01/12/2021 01/15/2021 51 F DIED ON 01/13/2021
955597 Death 01/13/2021 01/15/2021 50 M DIED ON 01/15/2021
955959 Patient died 1 week after vaccination.  According to family was having very rapid decline in status in recent weeks and they did not think related to vaccination. 01/11/2021 01/18/2021 82 M DIED ON 01/18/2021
956365 12/28/2020: generalized weakness and fell twice at home, cough, nausea,1/04/2021: cough, nausea, fever and chronic pain when she fell from being weak. admitted to hospital with Covid pneumonia, shortness of breath, covid postive, 1/09/2021: pt on bipap, 1/15/2021: pt was intubated, on TPN, pt DNR, 1/18/2021: was extubated and put on comfort measures and passed away 12/21/2020 01/04/2021 81 F DIED ON 01/18/2021
956458 Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing. 01/06/2021 01/14/2021 60 M DIED ON 01/16/2021
956761 Family was told that Patient expired in his sleep during the early morning hours of 1/15. I spoke with him the evening before (on 1/14), which was a day after he had received the Covid vaccine. He was not having any symptoms of allergy or reaction then. He did say that he felt tired, but he often complained of feeling tired over time. 01/13/2021 01/15/2021 94 M DIED ON 01/15/2021
956811 Resident was noted unresponsive, no respiration, no blood pressure, no pulse, code blue called according to facility protocol, resident is full code, CPR started, 911 called, arrived and took  over from staff. Resident was pronounced dead at 1:16pm 1/18/21 01/18/2021 01/18/2021 75 M DIED ON 01/18/2021
956843 Resident was found deceased in his bed at 7:15 am. 01/17/2021 01/19/2021 71 M DIED ON 01/19/2021
956903 mi Narrative: patient with asymptomatic covid 19, covid positive 12/10/2020. 12/22/2020 12/27/2020 86 M DIED ON 12/27/2020
956962 COVID 19 vaccine, unknown which company  Chronically ill in a skilled nursing facility found diaphoretic, hypotensive, hypoxia to 85% arrived to Emergency dept in cardiac arrest Died within 65 minutes of nursing finding patient in distress Wife felt it may have been related to vaccine date of vaccination 1/6/20 hx covid 19  PNA in April 2020 01/06/2021 01/19/2021 74 M DIED ON 01/19/2021
956966 hypoxia, secretions,cough, dyspnea Narrative: ALS patient on hospice with ongoing history of aspiration pna, receiving tube feeds. Developed incr in secretions, hypoxeia, temp and with recently noted clogged feeding tube. 12/25/2020 12/25/2020 86 M DIED ON 12/25/2020
956994 The patient had severe shortness of breath resulting in cardiac arrest on the 5th day after the vaccine. Shortness of breath started 12 hours after injection. On the 5th day, the patient was discovered to also have a rash throughout his body, but it is unknown when this rash started. 01/15/2021 01/15/2021 73 M DIED ON 01/19/2021
957116 Sudden death without warning symptoms 4 days after vaccine.  Many medical problems which most likely explain the outcome but spouse feels it is related and it is a new vaccine.  Monitor for pattern? 01/14/2021 01/18/2021 75 M DIED ON 01/18/2021
957163 Resident received 1st on 1/11/21 at 12:10am (1/12/21) resident was found unresponsive. Code Blue, 911 called at 12:11am. FD and EMS arrived, resident pronounced at 12:51am. 01/11/2021 01/11/2021 54 M DIED ON 01/12/2021
957799 Presented to Urgent Care for weakness and confusion, transferred to ED, patient had a cardiac arrest and was unable to be resuscitated 01/14/2021 01/15/2021 81 M DIED ON 01/15/2021
958069 Started with cough, mild shortness of breath and feeling terrible  in evening of 1/19. 01/14/2021 01/19/2021 94 F DIED ON 01/20/2021
958072 Death 3 days after receiving 2nd dose of COVID vaccine, unknown if related to vaccine administration. 01/16/2021 01/18/2021 57 F DIED ON 01/19/2021
958228 Patient has end stage renal disease and rapidly worsening dementia, family could no longer care for him at home, and he was admitted for 14-day quarantine prior to admission to inpatient hospice. Received vaccine on 1/12 without apparent adverse reactions. Patient started refusing oral intake on 1/16, and CMP on 1/17 showed hypernatremia 165 (new issue). His BUN 138 CREAT 6.93 K 5.2 were his baseline. He was found to be deceased on 1/18 at 11:18 pm. 01/12/2021 01/18/2021 83 M DIED ON 01/18/2021
958322 Shaking and then became unresponsive 01/19/2021 01/19/2021 62 M DIED ON 01/19/2021
958443 death by suicide Narrative:  death by suicide; 12/26/20, self inflicted gun shot wound; found deceased by family member 12/24/2020 12/26/2020 1 F DIED ON 12/26/2020
958745 Resident was noted to have increase weakness on 1/15/2021.  Resident was warm to touch with low grade fever of 99.3 F.  Resident was up propelling self in w/c on 1/16/2021 he was pleasant, accepted medications and ate lunch.  He was found slumped over in his w/c not responding and vital signs absent. 01/12/2021 01/14/2021 73 M DIED ON 01/16/2021
958914 Death on 1/15/2020 12/30/2020 01/15/2020 87 F DIED ON 01/15/2021
958935 Sudden Death within 24 hours of vaccine 01/19/2021 01/20/2021 92 F DIED ON 01/20/2021
958971 Hemorrhagic Stroke,  Right Basal Ganglion 01/13/2021 01/14/2021 84 M DIED ON 01/14/2021
959001 Patient woke apx 0200 complaining of nausea to group home staff.  Vitals were checked at that time and WNL.  Patient went back to bed.  When staff went to wake patient apx 0530, he was unresponsive and had no pulse. Chest compressions were started and EMS called. 01/15/2021 01/16/2021 55 M DIED ON 01/16/2021
959079 On 1/9/2021 observed  with elevated respirations of 38-42 per minute, BP manually 72/50. pulse is jumping rapidly between 110-16 bpm. oxygen sat 76% RA, resident refusing oxygen at first attempt, allowed oxygen to be placed, is now 84% on 4L. resident shaking head yes that he is hurting, and yes that he would take medication for pain. Dr. notified,   branch block.  Received order for morphine 2mg per hr as needed for elevated respirations and pain. Dr. also gave orders to D/C Tamsulosin and finasteride.  Resident continue with decreased O2 sats and elevated respirations. Absence of vital signs on 1/10/21 at 826PM. 01/06/2021 01/09/2021 91 M DIED ON 01/10/2021
959167 Patient received COVID 19 vaccine 01/14/2021. Patient died in his sleep 01/16/2021. 01/14/2021 01/16/2021 84 M DIED ON 01/16/2021
959179 Patient received COVID-19 vaccination on 1/14/2021. On 1/17/2021, patient was transferred to Hospital s/p multiple cardiac arrests. Patient was hyperkalemic and in acute renal failure at time of transfer. Hyperkalemia was treated, but the patient suffered PEA vs VFib. At the time of transfer, patient was on vasopressin, norepinephrine, and epinephrine. The patient had an EF of 40-45% and elevated troponins.  Patient was made DNR and placed on comfort care. Patient passed away on 1/18/2021. Ultimately we suspect that the patients condition was a direct result of his underlying disease states, but wanted to make sure reporting was made available. 01/14/2021 01/17/2021 79 M DIED ON 01/18/2021
959272 Patient died 4 days after immunization.  Probably unrelated to immunization, as patient has been in poor health and was receiving hospice services.  I have no details related to his illness or symptoms.  Daughter is the HIPAA/emergency contact and will have all the information needed. 01/12/2021 01/15/2021 85 M DIED ON 01/15/2021
959356 Pt passed away the day after the vaccine was given. 01/13/2021 01/14/2021 89 F DIED ON 01/14/2021
959568 Patient received her first dose of the Moderna COVID-19 Vaccination on Saturday January 16th 2021 at approximately 12pm. She completed all necessary screening forms and was deemed to be at low risk for serious allergic reactions. She tolerated the vaccination well, and no complications or immediate adverse events occurred. She was observed for a full 15 mins per CDPHE/CDC guidelines and left the Clinic in stable condition after her observation period was complete. On the morning of Tuesday, January 19th, 2021, the patient was found unconscious and unresponsive by her husband. She was transferred by Ambulance to Hospital shortly thereafter. She was diagnosed with a brain bleed that was determined to be inoperable. She was transferred to other Hospital for higher level care. She was seen by neurosurgery and diagnosed with a ruptured aneurysm. She was treated in the ICU for 24 hours, at which point her team determined that the severity of her brain bleed would not respond to treatment. Supportive cares were withdrawn on Wednesday Jan 20th, and she passed away shortly thereafter. 01/16/2021 01/19/2021 70 F DIED ON 01/20/2021
959591 Resident has increase weakness and lethargy with abnormal labs.  He was transferred to the ER.  He was admitted to the hospital and treated for worsening AKI and hypotension. 12/22/2020 12/31/2020 70 M DIED ON 01/17/2021
959929 Narrative:  Patient seen in ED 1-17-21 with c/c of "bloated with epigastric pain". Patient with complicated medical history including stage 1B pancreatic cancer (was currently on chemotherapy mFOLFIRINOX), and a leadless permanent pacemaker implantation on 1-11-21 for long episodes of SR with complete heart block following symptoms of syncope (other cardiac history: CAD s/p CABG 2009, PAF, and HTN). Regarding ER visit for epigastric pain, nothing notable was found on workup and patient was to discharge home to rest. There were available doses of COVID-19 Vaccine following a vaccine clinic that same day, and patient was offered and agreed to a dose of vaccine. Patient was monitored for 15 minutes post vaccine with no notable issues. The following day, Monday 1-18-21, patient's caregiver called facility at 22:30 to report he had a fever of 102.8 degrees and that he had been "feeling kind of bad all day". Patient was advise to seek urgent medical care and reported back to ED on 1-19-21 at 00:55. Patient wasd admitted for SIRS (tachycardia and febrile) -- patient also reported diffuse myalgia. WBC WNL, CXR unremarkable for infection, UA neg for bacteria, LFTs WNL, blood cultures negative. Procalcitonin elevated at 17.8 -- suggesting inflammatory response. Patient initially reported feeling better on the morning of 1-19-21, but around 13:00 began rapidly declining (confusion, unable to walk) and started experiencing EKG changes (9 beats of SVT). Patient then coded and resuscitation was attempted for approximately 30 minutes. Patient did not survive the code. Coroner has been notified and family is considering autopsy at time of this report. 01/17/2021 01/18/2021 70 M DIED ON 01/19/2021
960437 platelets dropped so low/thrombocytopenia; Hemorrhagic stroke/brain hemorrhage; This is a spontaneous report from a contactable nurse. A 56-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on 18Dec2020 at single dose for covid-19 immunisation. Medical history and concomitant medications were unknown. The reporter read about the doctor that died that developed thrombocytopenia after taking the vaccine, stated it was in the news yesterday. The patient received the Pfizer Covid vaccine on 18Dec2020, and he died 16 days later from a brain hemorrhage. Autopsy stated that said he had a hemorrhagic stroke on 03Jan2021. His platelets dropped so low that he had specialists that tried to get his platelet count back up again and they could not get his platelets back up again and he ended up having the hemorrhagic stroke.  The reporter already had thrombocytopenia and she was debating what she should do about getting vaccine. Outcome of the events was fatal.   Information on the lot/batch number has been requested.; Sender's Comments: Very limited information is currently available.  Lacking patient's underlying medical conditions, clinical course, relevant lab data, the Company cannot make a meaningful causality assessment.  The reported hemorrhagic stroke following low platelet count are managed as related to the suspect, BNT162B2, for reporting purpose only.   The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RA, IEC, as appropriate.; Reported Cause(s) of Death: Hemorrhagic stroke/brain hemorrhage; platelets dropped so low/thrombocytopenia 12/18/2020 01/03/2021 M DIED ON 01/03/2021
960460 died; tested positive for COVID; tested positive for COVID; This is a spontaneous report from a contactable consumer from a Pfizer-sponsored program, Pfizer First Connect. A 97-year-old male patient received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 30Dec2020 at 97-years-old at a single dose for COVID-19 immunization; administered by the nursing home.  Medical history included glaucoma from an unknown date and unknown if ongoing. Concomitant medications included: "used a sav for skin tears", and "eye drops for glaucoma" from an unknown date to an unknown date. On 07Jan2021, the patient experienced: tested positive for COVID (medically significant). The patient died (death, medically significant) on 17Jan2021. The clinical course was reported as follows: The reporter stated that in regard to the patient's height and weight: "was probably getting down to about five foot eight. Shrinking." The reporter stated that If she remembered correctly, they were trying to maintain the patient's weight 135 to 136 pounds.    The reporter stated that her father was in a nursing home. The patient received his first dose of the COVID vaccine on 30Dec2020. The patient died on 17Jan2021. The reporter stated that she "wanted Pfizer to know that the little old people in the nursing might not be strong enough for the vaccine." The reporter stated that she was "not calling to complaining."   The reporter stated that there was nothing wrong with her dad. He was elderly with no health issues.  "He was literally on no medications. The only reason he was in the nursing home was because he was afraid to walk." The reporter stated that she received a call about giving the patient the vaccine and she said yes because she wanted him to have the vaccine. One week after the vaccine, the patient tested positive for COVID "like all the other people" (no further details provided). The reporter stated that her dad had no symptoms of COVID. The director of nursing said the patient was doing so well. The patient ate his lunch, he laid down for nap, and at 14:30 he was gone. The patient "went peacefully in his sleep." The reporter then again stated that the patient literally had nothing wrong with him. "They were shocked. They fed him and he took a nap. He was sleeping, but it was eternally." The reporter stated that, "it might not have been the Pfizer vaccine, maybe his heart wore out."  In regard to an autopsy: the reporter stated that they would get it done if needed. The patient underwent lab tests and procedures which included COVID-19 virus test: positive on 07Jan2021. History of all previous immunization with the Pfizer vaccine considered as suspect: none.  It was unknown if there were additional vaccines administered on the same date of the Pfizer suspect, but the reporter doubted it. There were no prior vaccinations within 4 weeks. There were no adverse events following the prior vaccinations. The clinical outcome of the event, died, was fatal. The clinical outcome of the event, tested positive for COVID, was unknown. The patient died on 17Jan2021 due to an unknown cause of death.  An autopsy was not performed.  The batch/lot numbers for the vaccine, PFIZER-BIONTECH COVID-19 MRNA VACCINE, were not provided and will be requested during follow up.; Reported Cause(s) of Death: died 12/30/2020 01/07/2021 97 M DIED ON 01/17/2021
960552 At approximately 930am I arrived at Memory Care.  I met with the director of the facility and she directed me to where my team would be setting up.  My team consisted of (technician), (nurse) and I. As we were setting up, the director asked how she can help. I explained to her that we would need a designated area for patients to be monitored after vaccination for 15 minutes and maybe even longer . I also explained that we would need one of her staff monitoring while we vaccinate. She agreed, and proceeded to designate her staff and the cafeteria area, facing the vaccination station,the monitoring station.   Throughout the day, nurse and I were both vaccinating,while the staff of the facility would monitor the vaccinated patients. I would also stop occasionally to mix the vaccine and check the temperature of the aero safe.   At approximately 12:50pm, the director rushed in and stated that a patient is not responding, and that she had been vaccinated. At that point, I grabbed epipens and a thermometer and I also instructed nurse to grab an Epipen and come with me. We followed the director to pt's room. Once we got to the room, the patient was in bed and there were 4 staff members standing bedside and one of them turned and stated the patient has passed. At that point I asked the staff how long ago did the patient get the vaccine, they stated about 30 minutes ago. They also stated that the patient was a hospice patient and that the patient had declined, and was rapidly detiorating and had not eaten or drank anything all day . They also stated that the patient had been monitored for 15 minutes post vaccination. I then left the room and grabbed the patients COVID Vaccine intake consent form.     I looked at the answered questionaire and all the responses were circled NO. Patient had a temp of 96.5 at the time of vaccination.The vaccine administration information for Immunizer Section was filled out by Nurse. I then proceeded to ask the director once again if there were staff that was monitoring her for 15 minutes, the director stated they had staff monitoring her. She also stated the Hospice nurse has to announce her death, so they waited for the Hospice Nurse to come.  I then called Corporate and explained the situation. After speaking to corporate, I also asked nurse, if she remembered the patient. She stated that she did and at the time of the vaccination the patient was not alert, there were two staff members with the patient. She was non oriented and she kept closing her eyes. At that point, Nurse stated that she asked the two staff members with her if this is how she usually is and if its ok to vaccinate her. Both Staff members stated that it its ok,this is how she is. The Nurse then proceeded to vaccinate.  At approximately 3:10pm, as I was leaving I spoke to the director, and one of her Staff members. Staff that the patient has actually not eaten/ or drank anything for the past several days, including today(01/18/21). Staff also stated that on Friday, Jan 15th,2021, they had informed the family that the patient was rapidly detiorating. Staff also stated that the family knowingly gave the consent to vaccinate her. She also stated that the hospice Nurse believes that the death was primarily caused by her detiorating state. She also stated that the hospice Nurse informed that the death was not due to the Vaccine. Per Lead Pharmacist at the clinic. 01/18/2021 01/18/2021 78 F DIED ON 01/18/2021
960752 Extreme Fatigue 01/14/2021 01/14/2021 69 M DIED ON 01/16/2021
960841 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. 01/17/2021 01/19/2021 23 M DIED ON 01/21/2021
961010 Resident returned to the memory support unit at 1500.  Resident was than toileted and transferred in to bed per his request.  At 1515 resident was observed face down beside bed, resident sustained a 1inX1in eccyhmotic/hematoma to the forehead. Neuro Checks with in normal limes Vital signs: 100/52, 100, 97.2, 28.  Resident sent to ED for further medical evaluation via EMS. 01/19/2021 01/19/2021 92 M DIED ON 01/20/2021
961339 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. 01/18/2021 01/19/2021 45 F DIED ON 01/19/2021
961434 This is a 94-year-old male who is brought in by ambulance after being found on the floor with unknown downtime.  He was in asystole upon EMS arrival.  He remains in asystole.  No advanced airway is in place.  The patient is getting compressions from Lucas device upon arrival.  It was reported that he was last talked to by family at 2 PM.  The patient got his SARS-CoV-2 vaccination this morning.  The patient is evaluated emergently.  CPR was ongoing with 3 rounds of epinephrine given.  The patient remains in asystole.  He has rigor mortis.  The patient's pupils are fixed and dilated.  The patient has compressions paused and ultrasound is used to evaluate for cardiac activity.  None is detected.  The patient has no electrical activity on monitor.  The patient's time of death is 2113. 01/20/2021 01/20/2021 94 M DIED ON 01/21/2021
961705 approximately 3 hours prior to expiring the patient was experiencing forceful emesis.  later was found to have expired, patient was comfort care only. 01/18/2021 01/20/2021 60 M DIED ON 01/20/2021
961776 1/13/2021 12:00 PM: Patient received COVID-19 Vaccine. 1/14/2021 21:00: Nurse performed routine rounds and the patient appeared okay. 1/14/2021 22:00: CNA discovered patient unresponsive in bed, began CPR, and called 911. 1/14/2021 23:08: Pronounced deceased. 01/13/2021 01/14/2021 69 M DIED ON 01/14/2021
961845 Narrative: 01/12/2021 01/17/2021 77 M DIED ON 01/18/2021
962307 tired; legs felt heavy; stopped breathing; This is a spontaneous report from a Pfizer-sponsored program a non-contactable consumer. A 93-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 04Jan2021 11:00 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported.  Patient received vaccine around 11:00 a.m. About two hours later, he said he was tired and couldn't continue with the physical therapy he was doing. He was taken back to his room, where he said his legs felt heavy. Soon after, he stopped breathing. A nurse declared a do-not-resuscitate order. The patient died on 04Jan2021. It was not reported if an autopsy was performed. Outcome of stopped breathing was fatal. Outcome of tired and legs felt heavy was unknown.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: stopped breathing 01/04/2021 01/04/2021 93 M DIED ON 01/04/2021
962318 Called to schedule second vaccine and daughter reports that he died on01/19/2021 with "COVID" 12/29/2020 01/19/2021 80 M DIED ON 01/19/2021
962325 Patient's wife called this morning stating that her husband has passed away last night. After receiving first dose of Pfizer COVID-19 vaccine at around 0830, patient remained in the Immunizations Department for the 15-minute monitoring period. Per wife, patient's only complaint was pain at the injection site. At 1300, wife states that patient complaint of dizziness which "dissipated after a few minutes" followed by a headache which "dissipated after a few minutes" as well. Then patient complained of nausea, no vomiting and "couldn't relax." Per wife, from around 1400/1500, patient stayed on his recliner while still having a conversation with her--"he didn't get up to eat." Last conversation they had was around 2000/2100. Per wife, at around 2100/2200, patient was quiet and when she checked on him, "he wasn't responding anymore." Wife then called 911, "but they couldn't revive him." 01/20/2021 01/20/2021 80 M DIED ON 01/20/2021
962390 Admitted to hospital after vaccination with Acute hypoxemic respiratory failure, Septic shock;  Aneurysm of arteriovenous dialysis fistula; expired 1/16/2021 01/10/2021 01/10/2021 81 M DIED ON 01/16/2021
962714 We do not believe that the patient's death was an adverse event from the vaccine.  Patient received COVID vaccine from Pfizer Dose #1 12/19/2020 (lot # EK5730) and Dose #2 1/7/2021 (lot # EL1284). No side effects or adverse events noted; lived in 24/7 care facility and monitored twice daily for reaction.  Patient died 1/10/2021 from chronic respiratory failure and congestive heart failure after recent aspiration pneumonia requiring hospitalization. Death was anticipated and not sudden.  We were told to report his death to VAERS even though his death was anticipated and not related to his vaccination. 12/19/2020 01/10/2021 80 M DIED ON 01/10/2021
962716 Patient deceased 12/30/2020 01/19/2021 62 F DIED ON 01/19/2021
962764 Patient did not have any adverse reaction to the COVID vaccine, but we were asked by our health dept to submit a VAERS report since the patient died between his first and second dose.  Received Pfizer Dose #1 12/17/2020. No side effects or adverse events noted; lived in 24/7 care facility and monitored twice daily for reaction.  Date of death 12/23/2020 from aspiration pneumonia complicated by end-stage heart failure and ischemic cardiomyopathy. Death was anticipated and not sudden. 12/17/2020 12/21/2020 73 M DIED ON 12/23/2020
962784 patient expired 1/15/2021; had been treated as outpatient for pneumonia, likely COVID-19 but no positive test result in December 2020. PMH diabetes 01/09/2021 01/15/2021 88 M DIED ON 01/15/2021
962827 Admitted 1/14/21: Patient is an elderly 93-year-old female with multiple medical problems including chronic combined CHF, P 80, diabetes mellitus, HTN, hyperlipidemia, CKD stage 3, has been complaining of generalized weakness, fatigue, decreased appetite for the past few days.  She had an outpatient COVID-19 vaccine earlier today. Within 2 hr of admitting the patient to the hospital, condition clinically deteriorated.  Patient elected to be DNR/DNI while in the ED. Patient was pronounced dead at 10:30 p.m. earlier today.  Preliminary cause of death:  Hypoglycemia induced lactic acidosis. 01/14/2021 01/14/2021 93 F DIED ON 01/14/2021
962940 Pt received second dose of COVID vaccine on 01/20/2021 at 1430. At 1600 Pt developed a wet productive cough with coarse crackles. Pt ate dinner at 5 pm cough persisted. At 18:30 the nurse went to Pt's room to give him his medications. Pt still had a cough, denied shortness of breath. Pt was in a good mood and joking with staff. Pt asked to be shaved. At 19:45 Pt was sitting in the lounge and a CNA noticed that Pt was pale/white in color and clammy. 02 Sat was 85%. Respirations were labored. Pt was placed on 4 L of 02. Increased to 5 L via face mask and 02 sat was 89-90%. Ambulance was called at unknown time. Pt arrived at Medical Center at 2120 and was pronounced dead at 2127. 01/20/2021 01/20/2021 83 M DIED ON 01/20/2021
962966 On Saturday, 1/16/2021, Patient went to the grocery store.  Upon her return, she indicated she was experiencing N/V and some throat swelling.  Patient subsequently collapsed and expired before she could be brought to an emergency room.  During  investigation by Coroners Office, it has been reported that Patient may have gotten some takeout food while she was out.  Labs are pending and the Coroners investigation is ongoing. Spouse believes that her death was caused by the vaccine. 01/14/2021 01/16/2021 80 F DIED ON 01/16/2021
962995 No immediate reaction. Patient-reported deceased four days later on Jan. 19, 2021. As of this date cause of death is unknown to our clinic. 01/15/2021 01/19/2021 61 M DIED ON 01/19/2021
963016 unknown.  Event occurred after leaving vaccination site 01/14/2021 01/15/2021 65 F DIED ON 01/15/2021
963057 presented to ED 1/9/21 with abdominal pain, progressive worsening weakness and fatigue and new onset A fib with RVR likely due to hypertensive urgency . Patient progressed clinically with severe hypoxia and transferred to ICU and started on BiPAP; progressive decline with decreased urinary output with uremia likely secondary to sepsis. Concern with patient worsening clinical decline, palliative care had been consulted on end of life care. Patient expired 1/17/21 01/09/2021 01/09/2021 96 F DIED ON 01/17/2021
963163 Narrative: 01/06/2021 01/08/2021 88 M DIED ON 01/08/2021
963167 Narrative: Symptoms:  & Cardiac Arrest; Death Treatment:  EPINEPHRINE 01/02/2021 01/04/2021 88 M DIED ON 01/04/2021
963235 Patient diagnosed with COVID on January 9, 2021 after being exposed to family member that was under quarantine in the same household.  Admitted to the hospital and was discharged on January 14, 2021 with home hospice.  Patient passed away on January 18, 2021 01/04/2021 01/09/2021 94 F DIED ON 01/18/2021
963269 Patient passed away on 01/18/2021 01/04/2021 01/18/2021 87 F DIED ON 01/18/2021
963388 Patient died unexpectedly 5 days after receiving vaccine (1/10/2021). 01/05/2021 01/10/2021 88 F DIED ON 01/10/2021
963610 Patient deceased on 01/17/2021 01/14/2021 01/17/2021 63 M DIED ON 01/17/2021
963902 Death; This is a spontaneous report from four non-contactable consumers via a Pfizer-sponsored program Corporate (Pfizer) Social Media Platforms.    A 78-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, on 28Dec2020 at a single dose for COVID-19 immunization.  Ongoing medical history included Alzheimer's Disease, encephalopathy, hypertension, acute kidney failure, urinary retention and recent urinary tract infection (UTI), all from an unspecified date.  Concomitant medication included acetaminophen (MANUFACTURER UNKNOWN), bisacodyl (MANUFACTURER UNKNOWN), bupropion (MANUFACTURER UNKNOWN), escitalopram (MANUFACTURER UNKNOWN), hydrocodone bitartrate, paracetamol (HYDROCODONE/ACETAMINOPHEN), loperamide (MANUFACTURER UNKNOWN), ondansetron (MANUFACTURER UNKNOWN), senna alexandrina (SENNA PLUS), vitamin d3 (MANUFACTURER UNKNOWN).  The patient had no known drug allergies. The patient experienced death on 30Dec2020.  The vaccine was given on 28Dec2020 with no adverse events and no issues on 29Dec2020.  The patient died on 30Dec2020, at approximately 2:00 AM.   It was unknown if an autopsy was performed.  It was unknown if the event was related to the suspect drug, the administrator marked as natural causes.    No follow-up attempts are possible; information about batch/lot number cannot be obtained.; Reported Cause(s) of Death: Death 12/28/2020 12/30/2020 M DIED ON 12/30/2020
964401 Pt died 4 days after vaccine, no known reaction to the vaccination 01/12/2021 01/16/2021 56 M DIED ON 01/16/2021
964617 Death, which I believe is unrelated to vaccination 01/08/2021 01/21/2021 77 F DIED ON 01/21/2021
964629 Death - Hospice patient with metastatic CA admitted to facility and received vaccine during stay. No adverse sequelae noted from vaccine administration, but reporting as required because pt died 7 days later. Narrative: Reporting this event because patient died 7 days after receiving vaccine in the facility where he was in hospice care for metastatic cancer. Vaccine was administered by protocol without complications. The patient had been asked and denied any prior severe reaction to this vaccine or its components and gave permission to receive it. No vaccine adverse sequelae were documented after the immunization as monitored for 15 minutes nor in facility notes for 7 days after the immunization. The patient's death was felt to be due to underlying terminal illness. 12/17/2020 12/27/2020 64 M DIED ON 12/27/2020
964636 Pt on hospice in facility for severe cardiomyopathy unable to perform interventions received vaccine without adverse sequelae died 5 days later. Reporting as required. Narrative:  Reporting as required patient death 5 days after immunization with Pfizer vaccine. However, no adverse sequelae were noted to the vaccine in the 15minute observation period, nor in the days following the immunization related to the vaccine. The patient denied any prior severe reaction to this vaccine or its components, and the patient gave verbal consent to receive the vaccine. Patient had been in the facility on hospice since 11/18/20 for severe decompensated HF and newly diagnosed cardiomyopathy, unable to perform interventions, also LE ischemic wounds with very poor potential to heal due to advanced PVD. 12/17/2020 12/22/2020 81 M DIED ON 12/22/2020
964653 loss of consciousness; respiratory distress Narrative: Patient tolerated his 1st dose of the COVID-19 vaccine well, on 12/16/2020, and received his 2nd dose on 1/6/2021. Patient had some mild clinical decline the past few days prior to 2nd vaccination, with a decreased appetite and some increased fatigue per nursing report, but no significant changes. He experienced nausea on the evening of 1/6/21, which was effectively managed, but by early morning he spiked a fever of 102.9 with a sat of 86.1%. He continued to deteriorate from that point on and died 1/7/21 @13:20. Clinically, the presentation was most consistent with an aspiration pneumonia. 01/06/2021 01/07/2021 79 M DIED ON 01/07/2021
964671 Death on 1-5-21 12/18/2020 01/02/2021 100 M DIED ON 01/05/2021
964724 Death 1-15-21 12/18/2020 01/15/2021 76 M DIED ON 01/15/2021