| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
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1 | Notes | VAERS ID | VAERS ID Code | Events Reported | Percent | Adverse Event Description | Lab Data | Current Illness | Adverse Events After Prior Vaccinations | Medications At Time Of Vaccination | History/Allergies | |||||||||||||||
2 | 1093939-1 | 1093939-1 | 1 | 0.45% | No report of negative event after 15 min wait past receipt of vaccine. Notified by Coronor, on 3/11/2021 that this patient expired on 3/11/2021 at home. Not sent to hospital. Pronounced at home. Sent to Funeral Home | None | Unknown | No prior vaccinations for this event. | Blood Thinner | Unknown,Unknown | ||||||||||||||||
3 | 1098028-1 | 1098028-1 | 1 | 0.45% | Cardiac arrest, death approx 12 hours later | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | levothyroxine | Hypothyroidism, MVP, valve repair, | ||||||||||||||||
4 | 1100865-1 | 1100865-1 | 1 | 0.45% | Patient died within 24 hours of vaccine. Unknown at this time if related. | Decedent is currently at facility awaiting further examination/investigation. | Hospitalized for Pneumonia 2-8-2021 | No prior vaccinations for this event. | Cefuroxime, Lansoprazole, Sulfasalazine, Azulfidine, Amoxicillin, Lisinopril, Fluticasone Nasal Spray, Tenormin, Atenolol, | Hypertension, obesity,Unknown | ||||||||||||||||
5 | 1102572-1 | 1102572-1 | 1 | 0.45% | Was notified by a third party that patient died on morning of 3/15/2021. No other information available. | unknown | arthritis, atrial fibrillation, congestive heart failure, diabetes mellitus, high cholesterol levels, hypertension | No prior vaccinations for this event. | Clobetasol 0.05% topical ointment, fluocinonide 0.05% topical cream, atorvastatin, daily multi-vitamin, glimepiride, metformin, clonidine transdermal, coumadin, folic acid, furosemide, hydralazine | aortic valve replacement,no known drug allergies | ||||||||||||||||
6 | 1102815-1 | 1102815-1 | 1 | 0.45% | Patient presented to hospital on 3/11 with shortness of breath. History of chronic oxygen dependency at night. Became more sob over last several days and was not able to make it to md appointment. Had a recent abnormal stress test. Family states she was febrile at home. Was low on oxygen level on 2LNC, placed on non-rebreather and then BIPAP. Positive for Rhinovirus. Chest xray showed bilateral lower infiltrates. Patient detiorated through the night and was intubated and placed on vasopressors for septic shock. Patient was made DNR and family refused hemodialysis. Family then made decision to withdraw care. | 3/11/21 Positive for Rhinovirus 3/11/21 Procalcitonin 54.97 and lactic acid 33.5 3/12/21 Procalcitonin 98.61 and lactic acid 72.4 | 2-3 weeks prior to vaccine was croupy and saw a pulmonologist and lungs were clear, on and off antibiotics from 2/12 to 3/5, failed stress test (occlusion of left anterior descending artery) and recommended cardiac cath and had a cardiac implant, possibly defibrillator. | No prior vaccinations for this event. | Advair, Alprozolam, Amlodipine, Aspirin, Atorvastatin, Azithromycin, Biotin, Cefuroxime, Dexilant, Dymista, Fenofibrate, Fluticasone, Hydrochlorothiazide, Incruse Ellipta, Isosorbide Monoitrate, Levothyroxine, Lipitor, Loratadine, Magnesium | COPD and Diastolic CHF, Pre-Diabetic, Hypertension,Penicillin | ||||||||||||||||
7 | 1103106-1 | 1103106-1 | 1 | 0.45% | Patient died on 01/24/2021. Began exhibiting symptoms similar to Covid 1 day after vaccination. | UNK | NA | No prior vaccinations for this event. | UNK | NA,NA | ||||||||||||||||
8 | 1103748-1 | 1103748-1 | 1 | 0.45% | Cardiac Arrest/Death | No lab data for this event. | unknown | No prior vaccinations for this event. | unknown | unknown,unknown | ||||||||||||||||
9 | 1104430-1 | 1104430-1 | 1 | 0.45% | Death Narrative: Patient has been admitted to a home hospice program since approximately 11/12/20 with an initial terminal diagnosis of dysphagia which was later changed in February 2021 to vascular dementia. Patient with significant past medical history of several CVA's which led to aphasia and vascular dementia. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
10 | 1104671-1 | 1104671-1 | 1 | 0.45% | Patient has a long history of seizures. He has seizures on a daily basis. He lives with his family, who are his primary caregivers, they family provides all of his activities of daily living. Patient received vaccine on Friday morning, feeling well throughout the day according to the father. Went to bed, during the night in bed he had seizures which is typical for him, and during the episode the father noticed that he had stopped breathing. called 911 who came to the house and the patient died in the house. I do not believe he went to the hospital. | None | Seizure disorder, severe mitochondrial myopathy, gastroesophageal reflux disease | No prior vaccinations for this event. | CoQ-10 200 mg twice a day, diazepam 10mg one as needed for seizures, Dilantin Infatabs 50mg 1 tab every morning. lamictal 150mg 2 tabs twice a day, midodrine 2.5mg 1 tab twice a day, vitamin D3 400IU daily. | Seizure disorder, severe mitochondrial myopathy,IV lactated ringers, midazolam, morphine, vancomycin | ||||||||||||||||
11 | 1106737-1 | 1106737-1 | 1 | 0.45% | weakness/malaise per daughter, death on 3/14 (did have underlying medical conditions) | none | Normal pressure hydrocephalus -- s/p VP shunt with dementia | No prior vaccinations for this event. | melatonin, calcium, vitamin D, famotidine, quetiapine 50 mg QHS | BPH, C-spine fracture with myelopathy, GERD,opiates, pencillins (hives) | ||||||||||||||||
12 | 1108312-1 | 1108312-1 | 1 | 0.45% | Severe exacerbation of idiopathic capillary leak syndrome 48 hours following administeration of Janssen vaccine leading to profound vasodilatory shock, renal failure and DIC and death | No lab data for this event. | none | No prior vaccinations for this event. | elavil, lisinopril, simvastatin, terbutaline, theophylline | Idiopathic Capillary Leak Syndrome,None | ||||||||||||||||
13 | 1110099-1 | 1110099-1 | 1 | 0.45% | 3/12/21 Sudden cardiac arrest at home; unable to be resuscitated at scene (Brother) Caller is a family friend who was asked by family to call and report incident. If f/u is needed, please contact him first. Current Medical History: unknown by caller Current Medications: unknown by caller | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
14 | 1111699-1 | 1111699-1 | 1 | 0.45% | Patient developed symptomatic COVID infection with symptoms starting 3/13, was admitted to the hospital for respiratory failure on 3/16 and expired on 3/18/21 | Positive COVID 19 test on admit CXR findings c/w COVID PNA Renal failure 2/2 COVID | None | No prior vaccinations for this event. | unknown BP med | Intellectual disability, hypertension,None | ||||||||||||||||
15 | 1112122-1 | 1112122-1 | 1 | 0.45% | Patient was admitted for Multi drug resistant UTI (for which he has been admitted many times before). Was hospitalized for 3 days while awaiting cultures, hemodynamically stable, with no lab abnormalities. On the day of discharge (sensitivities to UTI came back, pt to be discharged on cefepime, had PICC line) pt got up from bed, sat on the edge of the bed and was being given belongings by the nurse, alert and oriented and in a pleasant mood, when suddenly pt grabbed at his chest and stated ""I can't breathe"" and became combative and altered when O2 was attempted to be placed on pt's face; then pt had PEA arrest x3 and unable to achieve ROSC."" | None. Patient was being discharged. I suspected a massive PE however pt was on DVT prophylaxis. The coroner refused to do an autopsy so cause of death was not known but it was a highly unusual and unexpected outcome. | Complicated lower UTI (hospitalized for this- received vaccine in house) - MDR bacteria | No prior vaccinations for this event. | Macrobid 100 mg po BID Cefepime 2g daily (3/12-3/19) Dilaudid 2 mg po PRN pain gabapentin 600 mg BID Methotrexate qFriday Metoprolol 25 mg BID Odefsey (HAART) Mirtazipine daily Glipizide, insulin for DM2 | Neurosarcoidosis Transverse myelitis with lower paraplegia HIV positive (on HAART) DM2 MDD,PCN Cipro Ertapenem Fosfomycin | ||||||||||||||||
16 | 1112701-1 | 1112701-1 | 1 | 0.45% | Pt received COVID19 shot on 3/12/2021. Pt passed away on 3/15/2021. Dr called us to inform us that our patient had passed away but he did not believe it was caused by the vaccination at this time. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | warfarin, famotidine | ,penicillin | ||||||||||||||||
17 | 1114806-1 | 1114806-1 | 1 | 0.45% | Diagnosis: Cortical vein thrombosis, massive intracerebral hemorrhage with tentorial herniation, thrombocytopenia. Clinical Presentation and Course: 1 week after receiving Janssen COVID19 vaccination, patient developed gradually worsening headache. On March 17th, patient presented to Hospital with dry heaving, sudden worsening of headache and L sided weakness. Evaluation with head CT revealed a large R temporoparietal intraparenchymal hemorrhage with 1.3cm midline shift. She ended up getting intubated for worsening mental status. On evaluation at arrival in Medical Center, she was noted to have extensor posturing. Repeat imaging revealed worsening midline shift to 1.6cm. CTA showed cortical vein thrombosis involving the right transverse and sigmoid sigmoid sinus with tentorial herniation. Patient developed brain herniation and brain death was pronounced on March 18th, 2021. | CT Angiogram of the head 3/17/21: ""The supraclinoid ICAs are patent bilaterally. The right MCA is elevated by the large right hemispheric hematoma. There is no occlusion or significant stenosis involving the right MCA. The left MCA and bilateral ACAs are within normal limits. The intracranial vertebral arteries, left PICA, basilar artery and both PCAs are patent. There is no aneurysm or AVM. The evaluation of the venous structures is limited on this CTA but there is no opacification of the right transverse and sigmoid sinuses, suggestive of dural sinus thrombosis. Large right hemispheric hematoma is demonstrated with significant right-to-left midline shift measuring approximately 16 mm. Effacement of the right lateral ventricle and dilation of the left lateral ventricle. Right-sided transtentorial herniation is noted. IMPRESSION: 1. Suspect right transverse and sigmoid sinus dural sinus thrombosis. This can be confirmed with CTV if clinically necessary 2. No evidence of aneurysm or AVM to account fo" | Depression | No prior vaccinations for this event. | Fluoxetine | ,NKMA, No allergies | ||||||||||||||||
18 | 1117078-1 | 1117078-1 | 1 | 0.45% | Patient died approx. 5 hours after shot was administered. Cause of death reported is Atherosclerotic Cardiovascular Disease. The death certificate was signed by the county coroner without autopsy, based on the report by the onsite deputy coroner. No doctors or hospitals were involved. This report is FYI only; there has been no direct connection made between my mother's death and the vaccine other than one followed shorty after the other. | none | none | No prior vaccinations for this event. | Atenolol 50mg/day; unknown/various (B complex, metamucil tabs) | Hypertension,none | ||||||||||||||||
19 | 1118314-1 | 1118314-1 | 1 | 0.45% | She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021. Her autopsy is pending. | Autopsy | Addison's Disease, psoariasis | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
20 | 1124688-1 | 1124688-1 | 1 | 0.45% | Sudden death March 20, 2021 | None | Insulin Dependent DM, HTN, Hypercholesterolemia, Underweight, Hypothyroidism | No prior vaccinations for this event. | Atorvastatin, Levothyroxine, Novolog, Iron ,Lisinopril, Aspirin, | As above,None | ||||||||||||||||
21 | 1125903-1 | 1125903-1 | 1 | 0.45% | Patient stayed in health center under routine observation for 15-20 minutes after vaccine injection and showed no symptoms and was subsequently released to go home. A friend drove her home after her injection. On 3/19/21 at 09:09 a.m. a medical assistant from our facility called pt. to inform her of normal lab results. On 3/21/21 at approximately 05:43 p.m. the on call provider took a call from Deputy from the Sherriffs office informing us that pt. was found deceased in her bed on the afternoon of 3/21/21. | Recent labs performed include CBC on 3/18/21 but this was not related to the COVID 19 vaccination. | Thrombocytopenia (only on one lab, platelet count 122 on 2/26/21- repeat lab 3/18/21 revealed platelet count of 155) | No prior vaccinations for this event. | Amitriptyline, artificial tears, aspirin, atenolol, citalopram, clonazepam, glipizide, melatonin, Montelukast, multivitamin, omeprazole, refresh plus eye drops. | Chronic PTSD, hair loss, hyperlipidemia, controlled type two diabetes, dysthymic disorder, complicated grief,Acetaminophen, codeine, oxycodone, sulfa, morphine (none listed as anaphylactic type reactions) | ||||||||||||||||
22 | 1126732-1 | 1126732-1 | 1 | 0.45% | The decedent had significant medical conditions. The wife stated, the appointment for the vaccine shot was made on-line. Dept. of Health visited their home on 3/16. The shot was administered into the decedent's left arm at 0930hrs. The decedent expressed no health complaints and had no visible indications of adverse affects. The decedent was found not breathing supine in bed at 2347hrs 3/16 (same day as vaccine shot). | The decedent was transported to the Medical Examiner and an autopsy was performed. | None | No prior vaccinations for this event. | Atorvastatin, Carbidopa / Levodopa, Losartan, Metformin, Methenamine, Metoprolol, Clopidogrel, Venlafaxine, Vitamin D3, Baclofen, Felodipine . No over the counter medications/dietary supplements/ or herbal remedies | Parkinson's Disease, Multiple System Atrophy (MSA),None | ||||||||||||||||
23 | 1126863-1 | 1126863-1 | 1 | 0.45% | Patient was vaccinated in her home (COVID J&J) on 3/8. Vaccinator obtained consent and confirmed throughout the process that patient as at baseline since patient was nonverbal and bedbound. Later that same day she experienced an emergency and was take to the hospital and subsequently admitted to ICU. She died on 3/10, family present, on comfort care. Per HPI, ""Patient is a 85 y.o. female with advanced dementia (non verbal, wheelchair bound at baseline), chronic aspiration, recurrent UTIs, voiding dysfunction currently self-straight cathing, has suspicious bladder and gallbladder masses (being worked up), has right sided hydronephrosis, BIBEMS for acute hypoxemia, difficult to bag en route, ED had difficulty intubating and so performed cricothroidotomy. Patient had brief PEA arrest due to hypoxia. ED provider noted ""excessive pulmonary edema in airway, unfavorable anatomy, and airway swelling."" Suspected insult stemming from J&J COVID vaccination reaction."" | No lab data for this event. | CVA Chronic Aspiration Chronic PNA | No prior vaccinations for this event. | acetaminophen (TYLENOL) 325 MG suppository acetic acid (VOSOL) 2 % otic solution amLODIPine (NORVASC) 2.5 MG tablet Cholecalciferol (VITAMIN D) 125 MCG (5000 UT) Cap ciprofloxacin-dexamethasone (CIPRODEX) otic suspension Cyanocobalamin (B-1 | Chronic Aspiration Chronic PNA,None on file | ||||||||||||||||
24 | 1126876-1 | 1126876-1 | 1 | 0.45% | Patient passed away in the early morning of 3/13/21. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
25 | 1131084-1 | 1131084-1 | 1 | 0.45% | My sister died in her sleep six days after receiving the J&J vaccine in her sleep. | n/a no signs before her death. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Quadruple bypass in 2006. Stints in 2008., | ||||||||||||||||
26 | 1134651-1 | 1134651-1 | 1 | 0.45% | The patient had a hemorrhagic stroke approximately 3 days after receiving the vaccine and died. | No lab data for this event. | unknown | No prior vaccinations for this event. | Losartan | hypertension; hyperthyroidism,unknown | ||||||||||||||||
27 | 1134697-1 | 1134697-1 | 1 | 0.45% | Patient reportedly passed away on 3-24-21 on the day after the vaccine was given. We have no further information at our facility regarding the event. | unknown | No current illness for this event. | No prior vaccinations for this event. | unknown | ,no known allergies | ||||||||||||||||
28 | 1134819-1 | 1134819-1 | 1 | 0.45% | She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending. | CT scan on 3/14 showing a pulmonary embolus. Troponin normal, BNP Repeat CT scan on 3/17 showed interval expansion of bilateral pulmonary embolus. Labs demonstrated an elevated troponin, BNP. ECHO showed right heart failure. | Hypothyroidism Menometrorrhagia Morbid obesity Pulmonary emboli in 2016 | No prior vaccinations for this event. | No other medications for this event. | Hypothyroidism Menometrorrhagia Morbid obesity Pulmonary emboli in 2016,Shellfish | ||||||||||||||||
29 | 1139186-1 | 1139186-1 | 1 | 0.45% | Hospice of Compusus nurse called and reported that patient passed away. She reported no adverse reaction and that patient had no complications before going to bed and patient did not wake up from his sleep. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Parkinson's, COPD, Hypertension, Hypothyroidism, Sleep Apnea, Macular Degeneration,Sulphur, Penicillin | ||||||||||||||||
30 | 1141989-1 | 1141989-1 | 1 | 0.45% | Patient received Johnson and Johnson vaccine at approx 1:30 pm and passed away on 11:03 pm - May 24, 2021. Was told around 10;20 pm, the patient was experiencing trouble breathing, cold, clammy, non-responsive . | None provided by the facility, Family requested an autopsy and was declined by the Medical Coroner per nursing home. | none | No prior vaccinations for this event. | blood thinner - Eloquis high blood pressure medicine medicine for depression | COPD High blood pressure Protein C deficiency,N/A | ||||||||||||||||
31 | 1142078-1 | 1142078-1 | 1 | 0.45% | Patient was a high functioning 97-year-old female with a history of CLL diagnosed 1 year ago on no treatment prior to arrival, chronic stable thrombocytopenia, chronic kidney disease, past history of breast cancer and bladder cancer in remission, transfusion dependent anemia of chronic disease, covid 19 vaccination on 3/5/2021, who presented to the emergency room on 3/25/2021 unresponsive found by the family and emergency services was called. The paramedics found her temperature to be 101.6 and her room air sat was 87%. In the ER CT of the head revealed acute subarachnoid hemorrhage. There was no trauma. CT the abdomen and pelvis showed lymphadenopathy and splenomegaly consistent with her known CLL and new bilateral lung infiltrates. Patient's white blood cell count was 124,000 consistent with her known CLL. Patient prior was high functioning and still drove herself to her doctor's appointments. The day prior she told her son she was feeling slightly nauseous and ill and went to bed early. She was admitted with a subarachnoid hemorrhage which was felt to be spontaneous and not traumatic. She was not on any anticoagulation prior to arrival. She was also admitted with severe sepsis felt possibly due to aspiration pneumonia or pneumonia in general and she did have fever and bilateral infiltrates on imaging. covid 19 and influenza neg. The decision was made to place her on comfort care after discussion with family. She ultimately expired on 3/28 At 14:48 PM in the presence of her family | please see narrative above | None | No prior vaccinations for this event. | Zoloft, Xanax, levothyroxine, lovastatin, protonix | Chronic anemia Immune deficiency syndrome hx CLL- dx 1 yrs ago- was on no treatment Hypothyroidism Chronic stable thrombocytopenia with last known platelet count 95,000,pyridium | ||||||||||||||||
32 | 1142965-1 | 1142965-1 | 1 | 0.45% | Following the vaccination, individual ate lunch and then returned home. Later found deceased in chair in home ~8 hours after vaccine. No known symptoms. However no one was at home with individual for prolonged period of time during this time frame. | Autopsy performed on 3/19/2021 at NC OCME. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Morbid obesity, chronic acquired lymphedema, physical deconditionig, | ||||||||||||||||
33 | 1143912-1 | 1143912-1 | 1 | 0.45% | Suspected pneumonitis. Patient presented on day following vaccination as shortness of breath, nausea, and diarrhea were not abating with home management. They had started later in the day after the vaccination. At ER admission - SpO2 = 80% room air. Nasal cannula was applied and SpO2 recovered quickly. BNP was elevated so acute exacerbation of heart failure was suspected and treated. However, patient did not improve with diuresis. Viral workup and bacterial cause workup negative. No acute cardiac events discovered. Patient continued to decline. Transferred to ICU on 3-19-21 to use BiPAP with 65% FiO2 and able to take breaks to 15L nasal cannula. Borderline blood pressures at this time. Infectious disease, pulmonology, cardiology, nephrology, and critical care anesthesia services evaluated and ruled out multiple possible diagnoses and patient continued to decline. Diagnostic bronchoscopy on 3-22-21 with BAL lead to patient ventilator dependent with profound hypotension. Aggressive ICU management ensued. Bronchoscopy very clean with no real secretions - in line with CT evidence of pneumonitis. Despite aggressive care and maximized pressor support, patient expired on 3-29-21 when family chose to withdraw care as blood pressure declined again. | Lots. CBC with autodifferential and bmp every day from 3-11-21 to 3-28-21 In addition: 3-11-21: CXR, CT angiogram with contrast, COVID testing, , blood cultures, urine culture, ddimer, esr, cmp, bnp, lipase, troponin; INR 3-12-21: respiratory pathogen testing; repeat COVID PCR testing; INR, iron studeis, CMP 3-15-21: CT head 3-19-21: COVID IGG testing and PCR repeat; blood cultures; CXR, abdominal XR 3-20-21: blood cultures; CXR 3-21-21: CXR 3-22-21 - bronchoscopy with BAL; pre and post intubation CXR 3-23-21: blood cultures; CXR; CT angiogram chest, CTAP 3-24-21: CXR 3-25-21: CXR 3-26-21: CXR 3-27-21: urine and blood cultures; CXR 3-28-21: CXR | no acute illnesses | No prior vaccinations for this event. | amiodarone, aspirin, atorvastatin, Entresto, escitalopram, ferrous sulfate, gabapentin, chewable multivitamin, niacin controlled release, omeprazole, warfarin, tramadol, tempazepam | dual chamber ICD placement 2-2021; Aortic valve replacement (long time ago), hyperlipidemia, depression, rEFHF, pAF, osteoarthritis, hypertension,nkda | ||||||||||||||||
34 | 1144220-1 | 1144220-1 | 1 | 0.45% | Bacteremia - strep epidermidis, developed respiratory distress required intubation for hypercapnic respiratory failure. Developed PEA on 3/28 died. | Blood cultures Ct Brain 3/16 Ct thorax 3/16 Ct abdomen 3/16 Chest X-ray 3/16, 3/17, 3/18, 3/20, 3/22, 3/24, 3/25, 3/26, 3/27 Us LE venous duplex 3/16 US gallbladder 3/16 CBC, CMP daily from 3/16-3-27 Cardiac telemetry | No current illness for this event. | No prior vaccinations for this event. | Loratadine Coreg Protonix Flonase Synthroid Alprazolam | Atrial fibrillation Hypertension Hypothyroidism Anxiety Allergic rhinitis,Losartan Penicillin | ||||||||||||||||
35 | 1144617-1 | 1144617-1 | 1 | 0.45% | Patient was found deceased in her home by her daughter 9+ hours after receiving the vaccine. The was no indication of how long the patient had been deceased prior to being discovered. | No lab data for this event. | None per chart | No prior vaccinations for this event. | allopurinol (ZYLOPRIM) 100 MG tablet Take 1 tablet by mouth daily. lisinopril (ZESTRIL) 10 MG tablet Take 1 tablet by mouth daily. metFORMIN (GLUCOPHAGE) 1000 MG tablet Take 1 tablet by mouth 2 times daily with meals. pravastatin (PRAVACHOL | Hypertension High cholesterol Diabetes (CMS/HCC) Gout Obesity BMI 34.0-34.9,adult,Codeine - Unknown Atorvastatin - Nausea Only Simvastatin - Nausea Only | ||||||||||||||||
36 | 1146022-1 | 1146022-1 | 1 | 0.45% | on 3/24, she had decreased level of alertness, eating less, but continued to drink. On 3/25, appeared a bit better, but still not at baseline. drinking fluids but not eating. she vomited up black material and then passed away on 3/25. | none | No current illness for this event. | No prior vaccinations for this event. | tylenol, norvasc, aspirin, celexa, metoprolol tartrate | CAD, CHFrEF, dementia, essential tremor,no true allergies | ||||||||||||||||
37 | 1146768-1 | 1146768-1 | 1 | 0.45% | Death | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Diabetes, COPD, | ||||||||||||||||
38 | 1147618-1 | 1147618-1 | 1 | 0.45% | cardiac arrest | none | No current illness for this event. | No prior vaccinations for this event. | metformin, coreg, proton pump inhibitor | diabetes, hypertension, alcohol use, anemia,sulfa | ||||||||||||||||
39 | 1153885-1 | 1153885-1 | 1 | 0.45% | ASYSTOLE; PASSED AWAY; This spontaneous report received from a physician concerned their mother-in-law, an female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient was in a nursing home, but was hospitalized for pyelonephritis. The patient was not allowed back into the nursing home without a negative COVID test and the vaccine. After discharge from the hospital, the patient's COVID test came back negative, and upon arrival to the nursing home, the patient received the Janssen COVID-19 vaccine. Within 30 minutes, the patient was unresponsive and transported back to the hospital. On arrival to the hospital, the patient was asystole. She was treated at the hospital until 13-MAR-2021, when she passed away. Asystole was reported as fatal. Additionally, cause of death was reported as ""cause unknown"", therefore, an additional serious adverse event of ""passed away"" was captured. An autopsy was not performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died on 13-MAR-2021. This report was serious (Death and Hospitalization).; Sender's Comments: V0: An female of unknown age became unresponsive 30 minutes after, experienced asystole on the same day as, and died of unknown causes 2 days after receiving Janssen COVID-19 Vaccine Ad26.COV2.S (suspension for injection; route of administration and batch number unknown) for prophylactic vaccination while in a nursing home. Medical history and concomitant medications were not reported. The patient was the mother-in-law of the reporter, an internal medicine physician. The patient had no complaints for 30 minutes after receiving the vaccine, then became unresponsive; she was transported to a hospital where she was noted to be asystolic upon arrival. Treatment and hospital course were not provided. The patient died 2 days after receiving the vaccine, and cause of death was unknown; outcome of asystole was reported as fatal. An autopsy was not performed. This case has insufficient information to make a meaningful medical assessment.; Reported Cause(s) of Death: ASYSTOLE; UNKNOWN CAUSE OF DEATH"" | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Comments: Unknown, | ||||||||||||||||
40 | 1154639-1 | 1154639-1 | 1 | 0.45% | Patient began having seizures about four hours post vaccine while at a friends house and passed away | Unknown | Unknown | No prior vaccinations for this event. | Unknown | Unknown,Penicillin | ||||||||||||||||
41 | 1155893-1 | 1155893-1 | 1 | 0.45% | pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground. | none. Last INR 2.7 Hga1c 6.4% | No current illness for this event. | No prior vaccinations for this event. | Tramadol HCl 50 Tablet Taking Lisinopril 40 MG Tablet Taking Allopurinol 100 Tablet Taking Atorvastatin Calcium 80 MG Tablet Taking Coumadin 7.5 MG Tablet Taking Desmopressin Acetate Spray Taking Atenolol 100 MG Tablet | paroxysmal Atrial fib- stable, INR, 2.7, Last stress test normal (more than 10 mets no difficulty) Diabetes stable Hga1c 6.4% Pituitary adenoma, | ||||||||||||||||
42 | 1157491-1 | 1157491-1 | 1 | 0.45% | COLLAPSED; HEADACHE; This spontaneous report received from a consumer concerned a 70 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802070 expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 11:00 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the patient experienced headache, was clammy to the touch. On same day at 14:00, checked blood pressure (BP) and it was 145/75 and his oxygen level read in the 90's. At 18:00, he collapsed while getting up out of his chair and emergency medical services (EMS) was called performed cardiopulmonary resuscitation (CPR) but never got him back. On 10-MAR-2021, the patient died from cause unknown. An autopsy was not performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of collapsed on 10-MAR-2021, and the outcome of headache was not reported. This report was serious (Death, and Other Medically Important Condition). The suspected product quality complaint has been confirmed to be no product quality complaint identified within the reported. Complaint is approved for void, based on the PQC evaluation/investigation performed. This report was associated with product quality complaint :90000173895.; Sender's Comments: V0: 20210341940-COVID-19 VACCINE AD26.COV2.S- COLLAPSED. This event is considered Unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.; Reported Cause(s) of Death: Cause unknown | Test Date: 202103101400; Test Name: Oxygen supplementation; Result Unstructured Data: 90's; Test Date: 202103101400; Test Name: BP; Result Unstructured Data: 145/75 | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Comments: Unknown, | ||||||||||||||||
43 | 1157494-1 | 1157494-1 | 1 | 0.45% | CARDIAC ARREST; This spontaneous report received from a consumer concerned a 53 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included type 2 diabetes, picc line, and diabetic foot ulcer. The patient had no known allergies. The patient had no previous history of heart conditions. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of admin not reported, batch number: 1805022, expiry: UNKNOWN) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. Concomitant medications included Ceftriaxone for diabetic foot ulcer, and Heparin for picc line prophylaxis. On Saturday, 20-MAR-2021, the patient reported that his chest felt funny but he wasn't sure about the cause. On Monday, 22-MAR-2021 morning; the patient had collapsed when he got out of the shower and yelled for help. The patient was gasping for breath and reading on pulse oximeter dropped into the 70's and also reported that he felt light headed. It was unknown weather the patient died in ambulance or at hospital. It was unspecified if an autopsy was performed. Laboratory data included: Oxygen saturation decreased (NR: not provided) Dropped to 70's. On 22-MAR-2021, the subject died from cardiac arrest. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. This report was serious (Death).; Sender's Comments: V0: 20210342361 -COVID-19 VACCINE AD26.COV2.S- Cardiac Arrest. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: MEDICAL HISTORY.; Reported Cause(s) of Death: CARDIAC ARREST | Test Date: 20210322; Test Name: Oxygen saturation; Result Unstructured Data: Dropped to 70's | Central line placement; Diabetic foot ulcer; Type II diabetes mellitus | No prior vaccinations for this event. | CEFTRIAXONE; HEPARIN | Comments: The patient had no known allergies. The patient had no previous history of heart conditions., | ||||||||||||||||
44 | 1157506-1 | 1157506-1 | 1 | 0.45% | FEELING BETTER FOR THE MOST PART; DEATH; LOOKED PALE; STOMACH CRAMPS; EAR ACHES; ARM HURTS; BEYOND EXHAUSTED; HEADACHE; This spontaneous report received from physician via social media post and concerned a 25 year old female. The patient's weight, height and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration, and batch number were not reported) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-MAR-2021, the patient felt ""the vaccine is killing me today"" and ""its taking it's toll on me"". The patient was told that she looked pale on an unspecified date in MAR-2021. On 10-MAR-2021, the patient developed stomach cramps, ear aches, arm hurt, was beyond exhausted, and headache. On an unspecified date, the patient had reported feeling better for the most part. On 17-MAR-2021, the patient died from an unknown cause. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome for looked pale, stomach cramps, ear aches, feeling better for the most part, arm hurts, beyond exhausted and headache was unknown. This report was serious (Death).; Sender's Comments: v0 This spontaneous report from a physician reporting a social media post involved a 25-year-old female who received the Janssen COVID-19 Vaccine for prevention of COVID-19 infection and died approximately one week later. Medical history and concomitant medications were not reported. The patient reported no adverse effect on the day of the vaccination. The next day, she reported that ""The vaccine is killing me today. My arm hurts, beyond exhausted, headache, stomach cramps and earaches."" She also reported that people told her she looked pale. The following day, the patient reported that she was feeling better ""for the most part"". The patient died approximately 6 days later. No information was provided regarding the cause of death. There is insufficient information provided in this case to make a meaningful medical assessment.; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"" | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Comments: Unknown, | ||||||||||||||||
45 | 1157733-1 | 1157733-1 | 1 | 0.45% | Patient experienced a brain hemorrhage and was hospitalized on Monday, March 15. Despite numerous tests, doctors could not find the source or cause of the bleeding. Over time, the bleeding spread to other areas of her brain including her brain stem. Damage from the bleeding was so severe that she would not recover. She passed away on March 24 after being removed from life support. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | calcium channel blocker; anti-nausea medication | Polycythemia, | ||||||||||||||||
46 | 1160227-1 | 1160227-1 | 1 | 0.45% | death 5 days later | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | Aspirin, Cardizem, lisinopril, magnesium, potassium, Symbicort, trazodone, vitamin c, risperidone, vitamin D | COPD, dementia, oxygen dependent, atrial fibrillation,,penicillin | ||||||||||||||||
47 | 1161963-1 | 1161963-1 | 1 | 0.45% | DEATH; CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a male of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN, expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAR-2021, the subject experienced confirmed covid-19 infection. On 29-MAR-2021, the subject experienced death. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) Positive. On 29-MAR-2021, the subject died from unknown cause of death. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. On an unspecified date, the patient died from unknown cause of death, and the outcome of confirmed covid-19 infection was not reported. It was unknown if an autopsy was performed This report was serious (Death, and Other Medically Important Condition).; Sender's Comments: V0: 20210358262-COVID-19 VACCINE AD26.COV2.S- Death, Confirmed Covid-19 Infection. This event(s) is considered Unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH | Test Name: COVID-19 virus test; Result Unstructured Data: Positive | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Comments: Unknown, | ||||||||||||||||
48 | 1165154-1 | 1165154-1 | 1 | 0.45% | My husband died 18 days after the shot | Yes | Heart disease | No prior vaccinations for this event. | Heart meds, blood thinners, and blood pressure meds. | Heart disease,Penacilan | ||||||||||||||||
49 | 1167886-1 | 1167886-1 | 1 | 0.45% | Patient vaccinated against COVID-19; received COVID-19 Janssen vaccine on 3/10/2021. Patient developed symptoms last week of March. Called Provider with symptoms and then presented to the hospital (admitted on 4/1/2021). Tested for COVID and found to be positive. 4/1/2021. Patient declined, admitted to ICU on 4/3/2021. Patient died on 4/4/2021. Chief Complaint: HPI: Patient is a 79 y.o. yr. old female who presents today for COUGH (has had cough for a little over a week) and FEVER (on and off for about a week)Patient was seen due to feeling ill for over week. Patient states that she was trying to fight it on her own but symptoms have been progressing. Patient has felt feverish no known fevers. Has had a persistent now worsening cough. Patient is feeling very tired and weak due to being sick for over week. Patient does live alone. Patient is coughing which is productive with sputum. Patient is eating and drinking well. No N/V/d. No loss of taste or smell. No recent ill exposure.; Has had covid vaccine. Patient did get the Johnson and Johnson vaccine over a month ago. Patient is feeling very fatigue; Having feverish/chills. Patient is taking OTC nightquil which is no longer helping. Patient does see oncologist for her CLL. DISCHARGE DIAGNOSIS: 1. Deceased 2. COVID-19 with hypoxia 3. Asthma 4. Anemia DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 HOSPITAL COURSE: Patient is a 79 year old female who was admitted on 04/01/2021 for COVID-19 pneumonia with complications of hypoxia. Patient's symptoms of cough and shortness of breath have been present for approximately 2 weeks. It was noted that 1 month ago she did receive the Johnson & Johnson vaccine. Upon admission patient was treated with azithromycin, Rocephin to cover for secondary bacterial infection. She was not a candidate for remdesivir due to the length of her symptoms. She was started on Decadron, as well as gentle fluids due to tachycardia for approximately 12 hours. During the night of 4/2-4/3 patient progressively declined requiring more oxygen she was transferred to the intensive care unit. Patient was a do not resuscitate continued decline and after exacerbating all treatment options patient was switched to comfort care earlier this evening. Pronounced dead at 6:45 a.m. | + COVID - positive 4.1.21 Troponin - 15 elevated D-dimer - 4370 elevated | NA | No prior vaccinations for this event. | NA | Leukemia, GERD, depression, breast cancer, rectal cancer, lymphocytic leukemia, chronic lymphocytic leukemia, hypocalcemia, anemia,NA | ||||||||||||||||
50 | 1168142-1 | 1168142-1 | 1 | 0.45% | ER 3/17 HPI: 72 y.o. female who presents with generalized weakness and not feeling well. Patient states that she had her 1st dose of COVID-19 vaccine about a week ago and since then has not felt well. She denies fever or chills, she denies any arthralgias or myalgias, she has had some nausea and vomiting but none in the last couple of days. There has been no diarrhea. There have been no urinary symptoms. 3/22/21 Inpt Admission hpi 72 y.o. female who presents with shortness of breath and hemoptysis. Patient has known history of COPD and also has a history of squamous cell carcinoma of the lung that is in remission. Patient reports she has noticed increasing shortness of breath for the past several weeks. She states the got worse around the noon time today. Patient reports she began having some hemoptysis today. Patient denies any chest pain or palpitations. Patient denies any fevers or chills. Patient denies any sinus congestion or nasal drainage. Patient denies any headaches, myalgias, or loss of sense of taste and smell. Patient does report a 4 day history of intermittent diarrhea. She denies any nausea or vomiting. Patient has had COVID-19 vaccination. Of note, patient's family reports she has lost 10 lb in the past 30 days. 3/30/21 Deceased | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | Current Outpatient Medications: ? albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% nebulizer solution, Take 1 vial (2.5 mg) by nebulization every 4 hours as needed for Wheezing, Disp: 360 mL, Rfl: 11 ? aspirin 325 MG tablet, Take 325 mg by mout | ,sulfa abx | ||||||||||||||||
51 | 1168291-1 | 1168291-1 | 1 | 0.45% | 3/22/21 Admission HPI: 71 y.o. male with a history of poorly controlled diabetes mellitus and COPD. He presented to my office today acutely with a several day history of increasing shortness of breath. He has increased his prednisone at home recently and been increasing the frequency of his DuoNebs. Despite this, he states that his oxygen saturations have been staying in the low 80s. He has a hard time walking due to the shortness of breath. He states previous to about a week ago he was doing very well. He denies any fever. He denies any known exposure to coronavirus (COVID-19). In the office today his oxygen saturations were 88% on 4 L. Because of his failure of outpatient therapy, he will be admitted to the hospital for further evaluation and treatment. This patient has a history of severe respiratory decompensation that happens very quickly. Therefore, it is medically urgent we get him into the hospital. 3/25/21 Admission HPI71 y.o. male with a known history of severe COPD and type 2 diabetes mellitus. He came to my office with a several day history of increasing shortness of breath. He had increased his oral steroids and breathing treatments at home and despite this was still having oxygen saturations in the low to mid 80s on 2-4 L of supplemental oxygen. In my office he was extremely diminished and had basically failed outpatient therapy. Therefore he was admitted to inpatient status for acute treatment of a severe COPD exacerbation requiring IV antibiotics and IV steroids. He was admitted and treated with IV treatments. He did recover nicely. However, he was found to be extremely physically deconditioned. Because of this he was thought to be an excellent candidate for swing bed and is being transitioned to swing bed. 4/5/21 ER Practitioner Note: Upon arrival to ED trauma room I found patient to be in cardiac arrest, CPR in progress. History is that EMS was called to the scene for a patient with chest pain. Shortly after arrival at his home patient developed a cardiac arrest. They followed standard ACLS protocol and the patient was intubated. Blood sugar normal. As CPR was given, medications were administered consisting of epinephrine and 1 mg in 2 different doses along with 1 amp of bicarb. IV access via an IO. Patient was then transported to the emergency department. Upon arrival, CPR was continued and oxygen supplied via endotracheal tube with good tube placement verified by auscultation and good sat readings. Monitor was placed and patient demonstrated initially a sinus rhythm but there was no pulse. Therefore, diagnosis was PEA and no reversible causes were identified. ACLS protocol was followed with epinephrine 1 mg IV every 5 min. He received a total that including EMS, 5 mg of epinephrine and 1 amp of bicarb. Monitor at this point revealed the rhythm changed to an agonal rhythm. When CPR was given, there was good results from the CPR. However, CPR discontinued and there is no pulse and patient had an agonal rhythm for several minutes, pupils were fixed but not dilated year. Lungs demonstrating clear bilateral breath sounds when he was bagged via the endotracheal tube. No external signs of any trauma noted. The patient's sister is here and she is a registered nurse. We had discussed management at this point with her and all were in agreement that the code be terminated. At 1015, patient was pronounced deceased.. ACLS protocol was followed. See nursing record for medication and vital sign details. Code outcome: Deceased CC time 20 minutes. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | Medications Prior to Admission Medication Sig Dispense Refill Last Dose ? allopurinol (ZYLOPRIM) 300 MG tablet 2 times daily Unknown at Unknown time ? amLODIPine (NORVASC) 10 MG tablet Take 1 tablet by mouth once daily 30 tablet 0 Unk | ,Allergies Allergen Reactions ? Codeine ? Hydrochlorothiazide ? Maxzide [Hydrochlorothiazide W/Triamterene] Renal failure ? Nitroglycerin Blood pressure drops | ||||||||||||||||
52 | 1168352-1 | 1168352-1 | 1 | 0.45% | Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused. | Autopsy including toxicology ( pending tax). COVID 19 test done at autopsy was negative. | none | No prior vaccinations for this event. | none other than eye drops | hypertension,unknown | ||||||||||||||||
53 | 1169584-1 | 1169584-1 | 1 | 0.45% | Patient appeared in no distress the day after vaccination other than complaint of nausea. It is unclear but patient expired sometime the night of 4/3/21 or early morning of 4/4/21 | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Reported CHF and COPD, | ||||||||||||||||
54 | 1170462-1 | 1170462-1 | 1 | 0.45% | Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body"" | none | Stasis dermatitis, GERD, HTN, chronic LBP. | No prior vaccinations for this event. | Naprosyn, Atenolol, Nitroglycerine, Tamsulosin, omeprazole, KCL, finesteride | HTN,IBU, clindamycin, Bactrim, ASA, Robaxin, | ||||||||||||||||
55 | 1173826-1 | 1173826-1 | 1 | 0.45% | Pt received the vaccine on 3/9/2021 reports to ED on 3/19/2021 s/p fall while transferring from wheelchair no fractures on x-ray, sent home at 2246. started to c/o chest pain and shortness of breath. Went into cardiac arrest at home approximately 4 hours after leaving ER. Pt was pronounced DOA 3/20/201 @ 0343 | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | Metformin Amlodipine lasix lovastatin meloxicam lisinopril zofran trazodone fenofibrate | Arthritis HTN DM HLD GERD,KNA | ||||||||||||||||
56 | 1175146-1 | 1175146-1 | 1 | 0.45% | Patient became weak within 24 hours and declined daily until she died on 4/5/21. Family wanted no intervention except comfort care given patient's wishes. | none | Baseline status, oxygen dependent, no new issues | No prior vaccinations for this event. | tylenol 500 mg Q12h | Chronic kidney disease Stage III, moderate dementia, pulmonary HTN, obesity, diaphragmatic eventration incontinence, atrial fibrillation, HTN,Folic acid 1mg QD , KCL 20 meq QD, albuteral nebs BID, synthroid 100 mcg QD, Lasix 40 mg QD, Paxil CR 25 mg QD, Diltiazem ER 120 mg QD, Vitamin D3 2000 IU QD, | ||||||||||||||||
57 | 1175492-1 | 1175492-1 | 1 | 0.45% | Janssen vaccine given on 3/9/2021; Admitted to the hospital on 3/16/2021 for COVID-19 infection, pneumonia, new onset a-fib, and COPD exacerbation. | Tested positive for COVID-19 on 3/17/2021. | COVID-19 infection | No prior vaccinations for this event. | unknown | unknown,unknown | ||||||||||||||||
58 | 1177248-1 | 1177248-1 | 1 | 0.45% | Family reports general malaise post treatment, followed by fever and chills 4/3/2021, and cardiac arrest 4/4/2021. | unknown | none that I am aware of. | No prior vaccinations for this event. | Alpahgan P 0.1% eye drops Amlodipine 5mg tablet Aspirin 81 mg tablet Delayed release Betimol 0.5% eye drops Calmoseptine 0.44%-20.6% topical ointment Carvedilol 12.5 mg tablet Hydralazine 50mg tablet lidocaine-prilocaine 2.5%-2.5% topical | Patient was placed on Hospice care the week of 3/29/2021.,Betadine- skin rash | ||||||||||||||||
59 | 1178909-1 | 1178909-1 | 1 | 0.45% | He complained Fever and after that shortness of breath, and when I tried to see a Doctor he suddenly collapse and died | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
60 | 1180895-1 | 1180895-1 | 1 | 0.45% | death Narrative: Pt with hx substance use disorder (on suboxone), depression, PTSD, SI and grief following her son's suicide. Pt received COVID vaccine 3/14/21. Clinic notified of pt's death on 4/6, for which it HAS NOT BEEN VERIFIED but reported death date of 4/3. Pt was scheduled for MH f/u appt 4/5, but no-showed it. Unclear report or cause of death, however, suspected via suicide or drug overdose given risk factors and worsening of mental illnesses. Was pt previously covid positive? No Are there any predisposing factors (i.e. PMH, HPI, allergy history etc) for patient experiencing adverse drug event? No Any occurrence of an ADR at time of administration or during time of observation? No Did patient recover from event? N/A - pt died but does not appear related to vaccine Was there an ADR between observation period and date of death? No Was patient hospitalized prior to vaccination? No Was patient hospitalized between vaccination and date of death? No Was patient hospitalized prior to death No What are the possible cause of death? Suicide, illicit drug overdose | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
61 | 1181925-1 | 1181925-1 | 1 | 0.45% | Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home. On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator. | I know they did an MRI and a CAT scan, an X-Ray, and they did a protein test on his spinal fluid. He also completed a course of Immunoglobulin therapy for GBS. | Car accident on 2/26, so neck and Lumbar pain. | No prior vaccinations for this event. | See additional space, Long list. | Heart Failure ~ 2017, Stroke ~ 2019, Hypertension, Diabetes.,N/A | ||||||||||||||||
62 | 1182258-1 | 1182258-1 | 1 | 0.45% | UKNOWN - SAW ON SOCIAL MEDIA THAT PATIENT PASSED AWAY ON 4/1/2021 | UNKNOWN | NOT KNOWN | No prior vaccinations for this event. | UNKNOWN ON DAY OF VACCINATION. ON 3/25/2021 RECIEVED 2 RXS: NAPROXEN 500MG TAB, DOXYCYCLINE HYC 100MG | NOT KNOWN,PENICILLIN, TETNUS, CODIENE, SULFA | ||||||||||||||||
63 | 1185219-1 | 1185219-1 | 1 | 0.45% | Patient was vaccinated on 3/30/2021. Found DOA on 4/8/2021. Last time anyone spoke with the patient was on 4/3/2021. | Unknown of Medical Examiner will be doing any testing. | Unknown | No prior vaccinations for this event. | Unknown | Unknown but patient was administered the vaccine at home due to report of homebound status.,None per Pre-Vaccination Checklist | ||||||||||||||||
64 | 1185285-1 | 1185285-1 | 1 | 0.45% | Pt received vaccine on march 11, 2021 went into E.R at Hospital and admitted 3/16/2021 Positive COVID-19 Pneumonia | No lab data for this event. | Hypoxia, COVID 19 pneumonia, COVID positive 3/16/2021 | No prior vaccinations for this event. | Albuterol CFC 90mcg/in 2 puffs PRN; Alprazolam 0.5mg 1 QD; ASA 81mg 1QD; Atorvastatin 10mg 1QD; Bupropion SR 200mg/12hr 1QD; Cyanocobalamin 1000mcg 1QD; Cymbalta 30mg BID; Dittiazem 60mg 1 Q12hr; Estrace 0.5mg ! QD; Lasix 20mg QD; Glipizide | Diabetes, BiPolar, HTN, Hypothyroidism. Fluid Overload, Hypercholesterol;,NSAIDs | ||||||||||||||||
65 | 1186471-1 | 1186471-1 | 1 | 0.45% | Complaints of diarrhea, sweating, weakness suffered sudden cardiac arrest. CPR, AED, Lucas device applied ACLS protocol initiated by EMS. Efforts terminated. Patient pronounced deceased at 1003am. | Resulted on 3/31/2021 FT4 - (NF) FT4 - FT4 L <0.25 (<0.25) 0.78-2.19 ng/dL T3 TOTAL - (NF) T3 TOTAL - T3 TOTAL LL 0.355 (0.355) 0.970-1.69 NG/ML TSH-HIGH SENSITIVITY - (NF) TSH-HIGH SENSITIVITY - TSH-HIGH SENSITIVITY HH 170.783 (171.219) 0.465-4.68 uU/mL | D-4 - POST-OPERATIVE ANALGESIA, MILD-TO-MODERATE - 2020-09-03 E78.5 - HYPERLIPIDEMIA, UNSPECIFIED - 2021-02-23 I10 - HYPERTENSION, UNSPEC. - 2019-02-04 F10.20 - **[F10.20A]** ALCOHOL USE DISORDER, MODERATE - 2019-02-11 F14.20 - **[F14.20A]** COCAINE USE DISORDER, MODERATE - 2019-02-11 D-19 - FRACTURED TOOTH - 2020-08-24 | No prior vaccinations for this event. | AMLODIPINE 10MG TABLET -- [TAKE 1 TABLET(S) ORALLY ONCE DAILY] -- 2021-02-23--2021-09-20 ATORVASTATIN 40MG TABLET -- [TAKE 1 TABLET(S) ORALLY ONCE DAILY] -- 2021-02-23--2021-09-20 LACTULOSE 10GM/15ML SOL -- [TAKE 30 MILLILITER(S) ORALLY TWI | D-4 - POST-OPERATIVE ANALGESIA, MILD-TO-MODERATE - 2020-09-03 E78.5 - HYPERLIPIDEMIA, UNSPECIFIED - 2021-02-23 I10 - HYPERTENSION, UNSPEC. - 2019-02-04 F10.20 - **[F10.20A]** ALCOHOL USE DISORDER, MODERATE - 2019-02-11 F14.20 - **[F14.20A]** COCAINE USE DISORDER, MODERATE - 2019-02-11 D-19 - FRACTURED TOOTH - 2020-08-24,VANCOMYCIN RELATED | ||||||||||||||||
66 | 1187758-1 | 1187758-1 | 1 | 0.45% | PATIENT WAS GIVEN JANSSEN COVID 19 VACCINE AT AROUND 12PM WHEN PATIENT WAS ACCOMPANIED BY HIS SON. HE WAS OBSERVED FOR 15 MINUTES AFTER THE VACCINATION AND LEFT PHARMACY WITHOUT ANY PROBLEM. PATIENT'S DAUGHTER CALLED AROUND 6PM AND REPORTED HER FATHER JUST DIED. SHE REPORTED HER FATHER ALL OF SUDDEN WAS SHAKING AND DIED RIGHT AFTER. | No lab data for this event. | UNKNOWN | No prior vaccinations for this event. | UNKNOWN | UNKNOWN,UNKNOWN | ||||||||||||||||
67 | 1188040-1 | 1188040-1 | 1 | 0.45% | nontraumatic subcortical hemorrhage of left cerebral hemisphere resulting in death | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | Trazodone, Namenda, HCTZ, proair, symbicort, estradiol, tylenol, xarelto, duloxetine, metoprolol, Vit D, oxycodone, gabapentin, sotalol, pramipexole, dicyclomine | Neuropathy, Edema, Dementia, HF, AFID, HTN,Penicillin and Streptomycin | ||||||||||||||||
68 | 1188278-1 | 1188278-1 | 1 | 0.45% | Patient collapsed & died 48 hrs. after receiving vaccine. He was shopping at local CVS store & collapsed without warning. Two nurses on scene at Clinic performed CPR immediately & applied AED. EMS arrived within 5 min. There was never a heart rhythm & after 35 min. of CPR was DOA at hospital ER. He had gone to the gym earlier at 7am & was having a normal day. He had not mentioned any complaints of not feeling well. | ER doctor stated he had enough risk factors to experience sudden death. I also realize he had risk factors but since all these reports are coming out about blood clots occuring I thought I should report it. | HTN, arthritis, chronic low grade B cell lymphoma, asthma, severe seasonal allergies plus other allergies to dogs, cats, mold, pollen etc., stent to carotid artery after surgical scar weakened | No prior vaccinations for this event. | Atenolol, Synthroid, Lisinopril, Zocor, Gabapentin, Allopurinal, AREDS eye pills, CoQ10, Norco | See above. No illness at time of vaccine,No | ||||||||||||||||
69 | 1189015-1 | 1189015-1 | 1 | 0.45% | Patient was given the vaccine without incident at or near 0924a. He previously was diagnosed, through PCR test to have COVID-19 back in December 2019. Outside of supportive therapy at home, he was not treated and was not hospitalized and he recovered within a few weeks. At or near 930-10p, on April 9th, approximately 12 hours after the vaccine was given, while out at a restaurant with family, the patient experienced a medical event, (what appears to be an acute coronary event) and died. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | medication for hypertension | hypertension, | ||||||||||||||||
70 | 1194600-1 | 1194600-1 | 1 | 0.45% | Death She was found Saturday Apr 10th deceased at her home. | Medical Examiner suspects cardiac event, however, she left work early not feeling well Thursday evening (falling asleep at work) and no one heard from her after that. No time of death has been given but we are assuming Thursday evening since no one heard from her. They are going to cremate her tomorrow and we want to make sure if any tests need to be done, we can have them hold off. We feel it necessary for you to do an autopsy to confirm cause of death. | No current illness for this event. | No prior vaccinations for this event. | Lisinopril We think High Blood pressure medicine as well She had been prescribed Sertraline but do not believe she was taking it | Asthma High Blood Pressure High Cholesterol,Penicillin and Shellfish | ||||||||||||||||
71 | 1195850-1 | 1195850-1 | 1 | 0.45% | Death by clot | No lab data for this event. | Rash/ allergy on arms, face chest and back . Approximate 1 month prior to vaccine, dermatologist placed him in antibodies, did not work, eventually placed on me drop back, and completed before johnson and johnson vaccine and was cleared by cop to get vaccine even thou rash was still present and not resolved. | No prior vaccinations for this event. | None | Diabetic, atrial fib. After receiving vaccine, my dad was found unresponsive, glucose elevated, unable to swallow, NG feeding tube placed and then spec tube on April , 2021. Shortly after returning ing to room after surgery, he died of blood clots! This man was eating and drinking before vaccine, CT of head shown no strokes on admission. The vaccine caused his glucose to elevate a lot, neurological changes happened, causing the swallowing reflexes to cease and then death by stroke!!!,Environmental, penicillin, erythromycin | ||||||||||||||||
72 | 1197086-1 | 1197086-1 | 1 | 0.45% | The individual complained of severe stomach pain - called 9-1-1 was unable to be revived. | No lab data for this event. | Unknown | No prior vaccinations for this event. | unknown | unknown,Bee venom | ||||||||||||||||
73 | 1198107-1 | 1198107-1 | 1 | 0.45% | 53 y.o. female with a PMhx of asthma, CHF, CKD (not on HD), DM, HTN, hypothyroidism, methadone dependence for back pain, chronic bilateral foot ulcers presents with c/o one day of fever and admitted for sepsis of unknown origin on 3/9. Patient tested negative for SARSCOV2 on admission on 3/9. She was deemed a candidate for the vaccine and it was administered on 3/10 (Janssen Lot 1805031). On 3/19, she tested positive for SARSCOV2. She developed worsening respiratory failure and required oxygen supplementation with gradual escalation until she was intubated on 3/29. She received 5 days of remdesivir and steroid therapy. She developed DIC for which she received supportive care (vitamin K, transfusions, etc) and an HLH-type picture for which the steroids treatment was prolonged. She was not a candidate for tocilizumab given the elevated LFTs > 5x the upper limit of normal. During the ICU course patient was started on hemodialysis. Patient gradually started improving around 4/5 with planning for spontaneous breathing trials in attempts to extubate after weaning of sedatives. On 4/8, during a dialysis session patient became hypotensive and bradycardic. After this episode, patient's mental status worsened and developed worsening metabolic acidosis and worsening shock refractory to vasopressors. Family decided for DNR and transition to comfort care. Patient expired on 4/12. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
74 | 1198162-1 | 1198162-1 | 1 | 0.45% | My sister received the Janssen vaccine on March 13, 2021. One week later, March 20, 2021, she started complaining of severe headaches, dizziness and vomiting. This continued so she visited the ER on Wednesday, March 24, 2021, where she suffered a cerebral venous sinus thrombosis. She was pronounced brain dead on March 27, 2021, which is also the same day she was pronounced dead. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
75 | 1198227-1 | 1198227-1 | 1 | 0.45% | SON REPORTED THAT PATIENT WOKE UP 4/7/21 WITH FLU LIKE SYMPTOMS AND STAYED IN BED ALL DAY. PT DID NOT DRINK ANYTHING OR TAKE INSULIN ON 4/7/21. WHEN DAUGHTER ARRIVED AT PTS HOME THAT EVENING, PT WAS INCOHERENT. SHE CALLED 911 AND PT WAS TRANSPORTED TO THE HOSPITAL WHERE HE PASSED AWAY ON 4/9/21. | CONTACT HOSPITAL FOR INFORMATION | No current illness for this event. | No prior vaccinations for this event. | ISOSORBIDE MONONITRATE 30MG, TELMISARTAN 80MG, HYDRALAZINE 100MG, OMEPRAZOLE 20MG, PREDNISONE 1MG, METHOTREXATE 25MG/ML INJ, ATORVASTATIN 80MG, LANTUS, NOVOLOG | DIABETES, ARTHRITIS, HEART,NKA | ||||||||||||||||
76 | 1198540-1 | 1198540-1 | 1 | 0.45% | Unknown if the vaccine has any correlation to event. Patient was found unresponsive and not breathing on 4/11/21 @ approximately 3:45 PM outside on the grounds of the campus. A rented scoter was next to him. There was no sign of trauma. 9-1-1 was called and CPR initiated by passerby (there were no witnesses). He remained unresponsive and was intubated when the paramedics arrived. He was transported to hospital where he was pronounced dead. | unknown what was done at hospital. | none known | No prior vaccinations for this event. | none known | none known,reported none on medical screening | ||||||||||||||||
77 | 1198782-1 | 1198782-1 | 1 | 0.45% | As described to me by her son: 04-01-2021 received vaccine , no issues, waited the 15 min and said she felt fine. Left with no issues. had been to see her MD that morning for routine visit and everything was fine. 04-02-2021: No issues - felt fine. Went shopping and out to eat. Was a bit tired that evening. Son left her home at 6pm and all was good. 04-03-2021: son text her in the morning and no answer. Thought she might be in the shower and text again and no answer. He called her and no answer, so he went over and found her non-responsive laying on her back on her bed with the same clothes she left her with the prior evening. sheriff's office pronounced her dead on 04-03-2021 with what appeared to have been a heart attack. | not informed of any | none I was aware of | No prior vaccinations for this event. | aspirin 81mg | none I was aware of,N/A | ||||||||||||||||
78 | 1199143-1 | 1199143-1 | 1 | 0.45% | Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021. | Surgery to remove pressure on brain and brain stem 04/06/2021. Surgeon noted alarmingly low platelet count. | prediabetic | No prior vaccinations for this event. | unknown | ,none | ||||||||||||||||
79 | 1200514-1 | 1200514-1 | 1 | 0.45% | Death on 4-5-21 the day after the shot. Bloody nose during that day | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Heart disease, | ||||||||||||||||
80 | 1200573-1 | 1200573-1 | 1 | 0.45% | She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage | You Can contact hospital are request for Laboratory REsults. Am not sure on how to provide the results | N/A | No prior vaccinations for this event. | Blood Pressure Medicine is being taken | Blood Pressure,N/A | ||||||||||||||||
81 | 1201130-1 | 1201130-1 | 1 | 0.45% | Death on 03/25/2021 ruled as cardiac arrest. | No lab data for this event. | None | No prior vaccinations for this event. | Aspirin, Metropolol | Stent placement,none | ||||||||||||||||
82 | 1201361-1 | 1201361-1 | 1 | 0.45% | Patient passed away between 3/30/21 and 4/1/21 at home. | None | Cancer of the lung, trachea and bronchus that had metastasized to the liver and adrenal gland. | No prior vaccinations for this event. | Atenolol 100 MG, Atorvastatin 20 mg, Oxycodone Acetaminophen 10-325, Amlodipine Besylate 10 mg, Oxybuynin CL ER 10 mg, Prednisone 10 MG, Glipizide er 5 mg, Potassium CL ER 20 meq, Xeljanz XR 11 mg, Captopril 50 mg, Hydrochlorothiazide 25 mg | Cancer of the lung, trachea and bronchus that had metastasized to the liver and adrenal gland., | ||||||||||||||||
83 | 1201543-1 | 1201543-1 | 1 | 0.45% | Death | CT of Head=Subacute left MCA territory infarct, Chest CT=Acute pulmonary embolism, right kidney and splenic infarcts, Upper extremity U/S=occlusive & nonocclusive deep vein thrombosis in the bilateral upper extremities, occlusive superficial venous thrombosis within the bilateral cephalic veins | unknown | No prior vaccinations for this event. | Diamox Unsure of other meications | Hypertension, Type2 DM, Idopathic Intercranial Hypertension, Obesity, Chronic back pain,Unknown | ||||||||||||||||
84 | 1201682-1 | 1201682-1 | 1 | 0.45% | PATIENT HAD DIZZINESS, WENT TO DR, THEN NEXT DAY ER AND ENDED UP DYING 4-2-2021 | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
85 | 1201835-1 | 1201835-1 | 1 | 0.45% | Low grade fever, aches & chills on 3/13/21 & 3/14/21. Felt better 3/15/21 through 3/18/21. Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21. Suffered stroke on 3/21/21 at 3:30 AM due to blood clots. Passed away on 3/22/21. | Network will have this information. I do not at this time. | Sleep Apnea | No prior vaccinations for this event. | BP, thyroid, cholesterol, headaches | Thyroid, headaches,None | ||||||||||||||||
86 | 1201889-1 | 1201889-1 | 1 | 0.45% | I am an investigator with the coroner's office. We have a death that occurred on 4/12/2021 that we ruled a natural death due to atherosclerotic cardiovascular disease. The family is concerned that the decedent was doing ""fine"" until she took the J&J COVID-19 vaccine on April 9, 2021. We DO NOT KNOW if the J&J vaccine caused this death, but are reporting it due to the close proximity of the vaccination to the death itself."" | No lab data for this event. | none | No prior vaccinations for this event. | high blood pressure meds - unk | high blood pressure, prior diagnosed heart conditions,none | ||||||||||||||||
87 | 1201981-1 | 1201981-1 | 1 | 0.45% | 7 days after the COVID vaccine, patient went into resp. arrest and died in the ER | No lab data for this event. | none | No prior vaccinations for this event. | glucophage for diabetes | diabetes- non-insulin, | ||||||||||||||||
88 | 1202019-1 | 1202019-1 | 1 | 0.45% | This patient was under hospice care at home with Nursing Service and Hospice. He received the J&J vaccination at noon by local public health nurse on Mon 4/12/21. The patient's wife, reported to hospice team that he had been sleepy during the day and had received a dose of Ativan earlier that morning (PRN medication at 0750). The primary hospice nurse reported wife noted he became more lethargic throughout the day after vaccination with his condition worsening at 1720; at that time his blood sugar levels were noted to be low at ""47"" but patient was alert enough to drink orange juice, eat ice cream. The patient continued to deteriorate so MD was consulted and he was transported to the ED where he later expired at 1930."" | No lab data for this event. | CHF, Atrial Fibrillation, Hypertensive Heart Disease, Ischemic Cardiomyopathy | No prior vaccinations for this event. | Amiodarone PO daily, Apixaban 5mg PO BID, Budesonide 0.5mg Inhaled BID, Clopidogrel 75 mg PO daily, Klor-Con M20 MEQ ER PO daily, Lantus insulin SC injection 24 units daily, Lipitor 40 mg PO daily, Metformin 500mg PO BID, Prednisone 20mg PO | Type 2 diabetes, COPD,No known allergies | ||||||||||||||||
89 | 1202456-1 | 1202456-1 | 1 | 0.45% | Death. My mother passed away 3/18/2021 from pulmonary arrest. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
90 | 1202482-1 | 1202482-1 | 1 | 0.45% | blood clots | unknown | unknown | No prior vaccinations for this event. | unknown | unknown,nka | ||||||||||||||||
91 | 1202969-1 | 1202969-1 | 1 | 0.45% | death Narrative: Patient with consistent decline over the last year; March 2021- increased confusion related to dementia, falls, hospitalizations wt loss. Enrolled in home hospice on 3/26 family's goal was to keep patient home and comfortable. Patient received J&J vaccine in the home through agency on 4/6/2021, Patient had a fall on 4/7/2021, Patient with rib pain after the fall no other injury noted. Patient passed away on home hospice on 4/11/2021. | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
92 | 1203337-1 | 1203337-1 | 1 | 0.45% | Brought to the ER as a code blue, 50 minutes down. CBC, CMP, and HIV screen completed. Deceased despite attempts of revival. Wife reports patient reported not feeling well, c/o feeling short of breath, started having foaming at the mouth, loss consciousness. He had pink sputum on arrival. | Platelet count 129, Hgb 10.6 | current chemo treatment for colon cancer | No prior vaccinations for this event. | Unknown by this reporter | Colon cancer,NKDA | ||||||||||||||||
93 | 1203631-1 | 1203631-1 | 1 | 0.45% | Flu like symptoms from the time received, patient passed away 03/11/2021 | Visit date 04/06/2021 | None | No prior vaccinations for this event. | Dilantin | , | ||||||||||||||||
94 | 1203799-1 | 1203799-1 | 1 | 0.45% | Patient developed chills and fatigue Saturday and Sunday (April 3rd and April 4th) . Patient developed diarrhea and lack of appetite Monday, April 5th. Patient was reported to be bedridden Wednesday, April 7th. Patients husband stated hat patients eyes were halfway closed, experiencing shallow breathing, and had a soft pulse. Husband call 911 while instructed to do chest compressions until EMTs arrived on site. First responder were reported to perform resuscitation efforts on the patient for 35 minutes until transporting the patient to the hospital. | Unknown | Unknown | No prior vaccinations for this event. | Unknown | Patient husband stated that patient had a pace-maker,Unknown | ||||||||||||||||
95 | 1203902-1 | 1203902-1 | 1 | 0.45% | Blood Clot which led to Pulmonary Embolism, Pneumonia, and death. | No lab data for this event. | diabetes, rheumatoid arthritis | No prior vaccinations for this event. | insulin methotrexate amlodipine hydralazine hydroxychlororoquine lisinopril folic acid | ,penicillin | ||||||||||||||||
96 | 1204016-1 | 1204016-1 | 1 | 0.45% | HE DIED SUDDENLY !!!!! JUST COLLAPSED !!!! | No lab data for this event. | None | No prior vaccinations for this event. | No other medications for this event. | None, | ||||||||||||||||
97 | 1204479-1 | 1204479-1 | 1 | 0.45% | Initially 2 to 5 days just fatigue. Evening of March 26th unusual fatigue and lower back to middle back discomfort low pain level. | None. Died in her sleep sometime the night of March 26 found at 5:30 AM morning of March 27 | None other than osteoporosis. | No prior vaccinations for this event. | Adult low dose 81mg, aspirin, Alprazolam 0.5, Amitriptyline, Atenolol, duloxetine, furosemide, Norco, simvastatin, sumatriptan, Pre Natel Vitamins. | Osteoporosis.,None | ||||||||||||||||
98 | 1204726-1 | 1204726-1 | 1 | 0.45% | Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness, lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | , | ||||||||||||||||
99 | 1205282-1 | 1205282-1 | 1 | 0.45% | Patient had a stroke 11 days later(on 4/6/21) and expired | No lab data for this event. | No current illness for this event. | No prior vaccinations for this event. | No other medications for this event. | Hypertension Diabetes, | ||||||||||||||||
100 | 1205684-1 | 1205684-1 | 1 | 0.45% | Blood Clot blocked oxygen to the brain. Suffered a severe stroke Was hospitalized Suffered brain swelling Lost brain function Died. | medical test can be retrieved from the hospital. They did CT scan, x-rays Most test were done on 04/04/2021 04/05/2021 And 04/06/2021 | None | No prior vaccinations for this event. | Olive leaf extract 750 mg L-lysine 1,000 mg Both once a day | None,None |