COVID Vaccine Injuries and Deaths – Part 2

This is Part 2 of another blog by the same name. To see Part 1, go here.

 

The following information was taken from this article at LifeSiteNews:

VAERS reports give detailed pictures of adverse events that have occurred. For example, the 929 COVID-19 vaccination-associated reported deaths include information about the patient’s age, state and how long after vaccination their symptoms began as in the following samples:

  • A 58-year-old Washington woman took Pfizer’s first dose of COVID vaccine at about 9 a.m. on January 4 at the medical center where she worked as a housekeeper and one hour later began to complain of nausea and feeling like she was going to pass out. By 3 p.m. that day, she “appeared tired and lethargic,” according to a VAERS report, and about 4 p.m. she “went into cardiac arrest and was unable to be revived.”

  • A 56-year-old man who worked at an extended care community facility in Florida received a second dose of Pfizer’s COVID vaccine on January 12 and was found “unresponsive,” within one hour. He was pronounced “brain dead” the same day and died two days later.

  • A 58-year-old woman walked to her car 20 minutes after receiving the first Pfizer vaccine dose in the state of Virginia on January 30. According to a VAERS report, she was leaning out of her car saying that she couldn’t breathe and began vomiting. She was administered two epi-pens and an epinephrine gas but became unresponsive shortly after she was put in an ambulance, where a “large amount of fluid was suctioned from the patients lungs,” and she was pronounced dead at the emergency department.

  • A 23-year-old New York man received a first dose of Pfizer’s COVID vaccine on January 17. “Patient developed 104.4 temp approximately 48 hours after being given the vaccine. I treated him with antibiotics, IV fluids, cooling methods,” stated one report filed by a physician. “Unfortunately, he suffered a cardiac arrest on 1/21/21 in the early morning and expired.”

  • A 28-year-old New Jersey man was due for his second dose of Pfizer’s vaccine January 11 but was was found unresponsive at his workplace in the hospital. His pupils were “fixed and dilated,” according to a VAERS report, and attempts to revive him were unsuccessful.

  • A 33-year-old woman died on January 28 following her first dose of Pfizer’s vaccine. The report filed by a physician stated that “16 hours after receiving the vaccine (the) patient was found dead at her home.”

  • A 43-year-old man who received Moderna’s COVID vaccine on January 8 in New York died the following day.

  • A 43-year-old woman with no pre-existing medical conditions and no known medications died six hours after receiving Pfizer’s COVID-19 vaccine on January 13, according to a VAERS report made by a pharmacist. “An autopsy was not performed. The cause of death was unknown, death unexplained. No follow-up attempts are possible. No further information is expected,” the report stated.

  • A 48-year-old Tennessee woman experienced a temperature, nausea and vomiting after her first dose of Moderna’s COVID vaccine on January 30 and died February 1.

  • A 49-year-old Alabama woman had her first dose of Moderna’s vaccine on January 15 and died within hours after suffering a seizure and heart attack.

  • A 53-year-old California man who received an injection of Pfizer’s COVID vaccine on January 4 began to feel unwell immediately, according to one VAERS report. “He went right home and went to bed.” The man slept intermittently and began vomiting and developed trouble breathing. He was taken by ambulance to an urgent care facility, where became increasingly “agitated,” he continued vomiting and was dehydrated. The following morning, according to the VAERS report, “The patient stated that he couldn’t breathe, and his mind was racing.” He died at 10:15 am on January 6 and, according to the VAERS report filed by his brother, “it was reported that none of the symptoms occurred until the patient received the vaccine.”

  • A 58-year-old Virginia pharmacist developed fatigue and shortness of breath hours after receiving Moderna’s second dose vaccine on January 21. He was hospitalized two days later as his condition worsened, but he repeatedly tested negative for COVID-19. He died on February 5.

  • A 52-year-old Hawaiian woman died two hours after receiving Moderna’s first dose of COVID-19 vaccine, after having a stroke.

The following information was posted at this link

The following screenshots were take from this video.  There are many more not shown here!

21-Year-Old University of Cincinnati Student DEAD 24 Hours after Johnson & Johnson COVID Injection< https://healthimpactnews.com/2021/21-year-old-university-of-cincinnati-student-dead-24-hours-after-johnson-johnson-covid-injection//h3>

Michigan Journalist Dies Day After Getting COVID-19 Vaccine https://thevaccinereaction.org/2021/04/michigan-journalist-dies-day-after-getting-covid-19-vaccine/

22-Year-Old Israeli Girl DEAD Following Experimental Pfizer mRNA COVID Injection https://healthimpactnews.com/2021/22-year-old-israeli-girl-dead-following-experimental-pfizer-mrna-covid-injection/

40-year-old Wisconsin teacher dead four days after Facebook “vaccinated” post https://healthimpactnews.com/2021/40-year-old-wisconsin-music-teacher-dead-following-experimental-covid-injection/

68-Year-Old Dies After Anaphylactic Reaction to COVID Vaccine https://childrenshealthdefense.org/defender/vaers-covid-vaccine-reactions-deaths-increasing/

63-Year Old North Carolina College Professor DEAD After Johnson and Johnson COVID Shot https://healthimpactnews.com/2021/north-carolina-college-professor-dead-after-johnson-and-johnson-covid-shot/

Woman Dies Minutes After Getting COVID-19 Vaccine at Cal Poly Pomona https://thevaccinereaction.org/2021/03/woman-dies-minutes-after-getting-covid-19-vaccine-at-cal-poly-pomona/

Doctor Mocks Anti-Vaxxers While Getting Experimental COVID Jab – Dies Days Later (Video) https://thewashingtonstandard.com/doctor-mocks-anti-vaxxers-while-getting-experimental-covid-jab-dies-days-later-video/

39-year-old nurse aide dies ‘within 48 hours’ of receiving mandated COVID-19 shot https://www.lifesitenews.com/news/39-year-old-nurse-aide-dies-within-48-hours-of-receiving-mandated-covid-19-shot

39-Year-Old Medical Doctor and Son of Former Chief Justice of Trinidad Found Dead After COVID Injection in Ireland https://healthimpactnews.com/2021/39-year-old-medical-doctor-and-son-of-former-chief-justice-of-trinidad-found-dead-after-covid-injection-in-ireland/

One dead, three neurologically disabled, ‘numerous’ reactions from vaccine in tiny Indigenous village https://www.lifesitenews.com/news/one-dead-three-neurologically-disabled-numerous-reactions-from-vaccine-in-tiny-indigenous-village

Another Medical Professional in the Prime of Life DEAD Weeks After Receiving the mRNA Experimental Injection as Memphis Mourns Loss of 36-Year-Old Doctor https://healthimpactnews.com/2021/another-medical-professional-in-the-prime-of-life-dead-weeks-after-receiving-the-mrna-experimental-injection-as-memphis-mourns-loss-of-36-year-old-doctor/

58-Year-Old Woman Dies Hours After Getting First Dose of Pfizer Vaccine https://childrenshealthdefense.org/defender/woman-dies-hours-after-first-dose-pfizer-vaccine/

39-Year-Old Woman Dies 4 Days After Second Moderna Vaccine https://childrenshealthdefense.org/defender/woman-dies-second-moderna-vaccine/

Healthcare Worker Dies 4 Days After Second Pfizer Vaccine, Death Under Investigation https://childrenshealthdefense.org/defender/healthcare-worker-dies-4-days-after-second-pfizer-shot/

Former Detroit TV Anchor Karen Hudson-Samuels Dies One Day After Taking COVID Vaccine https://detroit.cbslocal.com/2021/02/16/former-detroit-tv-anchor-dies-one-day-after-taking-covid-vaccine/

Miami Obstetrician Dies 16 Days After Getting COVID-19 Vaccine https://articles.mercola.com/sites/articles/archive/2021/01/28/dr-gregory-michael-covid-vaccine-death.aspx

45-Year-Old Italian Doctor “In the Prime of Life and in Perfect Health” Drops Dead After the Pfizer mRNA COVID Shot: 39-Year-Old Nurse, 42-Year-Old Surgical Technician Also Dead https://healthimpactnews.com/2021/45-year-old-italian-doctor-in-the-prime-of-life-and-in-perfect-health-drops-dead-after-the-pfizer-mrna-covid-shot-39-year-old-nurse-42-year-old-surgical-technician-also-dead/

California resident dies several hours after receiving COVID-19 vaccine; cause of death remains unclear https://www.foxnews.com/us/california-resident-dies-several-hours-after-receiving-covid-19-vaccine

60 year-old Health Care Worker Dies After Receiving Second COVID Vaccine https://www.bitchute.com/video/NeTZQEvrdWgT/

Teacher Dies Hours After Getting AstraZeneca COVID Shot in Italy – Manslaughter Investigation Launched https://vaccineimpact.com/2021/teacher-dies-hours-after-getting-astrazeneca-covid-shot-in-italy-manslaughter-investigation-launched/

Georgia (country): 27-year-old nurse dead 24 hours after AstraZeneca shot on camera https://thecovidblog.com/2021/03/21/georgia-country-27-year-old-nurse-dead-24-hours-after-astrazeneca-shot-on-camera/

Mexico: 75-year-old woman dead 15 minutes after Sinovac vaccine https://thecovidblog.com/2021/03/15/mexico-75-year-old-woman-dead-15-minutes-after-sinovac-vaccine/

Israeli Teenager Hospitalized in ICU for “Inflammation of the Heart” Days after Receiving Second Pfizer Vaccine https://healthimpactnews.com/2021/israeli-teenager-hospitalized-in-icu-for-inflammation-of-the-heart-days-after-receiving-second-pfizer-vaccine/

Indian Hospital Worker From UP Dies Just 24 Hrs After Receiving COVID-19 Vaccine Covishield https://greatgameindia.com/indian-dies-vaccine-covishield/

Indonesian Nurse Dies After Being Given COVID Vaccine https://childrenshealthdefense.org/defender/covid-19-vaccine-news/

75-year-old Israeli woman found lifeless hours after second dose of Covid-19 vaccine https://www.israelnationalnews.com/News/News.aspx/294861

3 Vaccination Deaths In 4 Days, What’s Happening In Telugu States? https://tolivelugu.com/three-corona-vaccination-deaths-in-four-days-tensions-in-telugu-states/

Odisha man dies after taking COVID-19 vaccine, another develops bacterial sepsis https://www.thehealthsite.com/news/odisha-man-dies-after-taking-covid-19-vaccine-another-develops-bacterial-sepsis-793037/

Pediatric Assistant in Portugal Is Dead Two Days After Taking Pfizer BioNTech COVID Vaccine https://thecovidblog.com/2021/01/08/pediatric-assistant-in-portugal-is-dead-two-days-after-taking-pfizer-biontech-covid-vaccine/

Tari Dailey: 73-year-old Iowa man dead hours after mRNA shot https://thecovidblog.com/2021/02/21/tari-dailey-73-year-old-iowa-man-dead-hours-after-mrna-shot/

Florida man dead days after second mRNA shot https://thecovidblog.com/2021/02/21/michael-ginesin-florida-man-dead-days-after-second-mrna-shot/

90-year-old Michigan man dead hours after Moderna mRNA shot https://thecovidblog.com/2021/02/19/daniel-thayne-simpson-90-year-old-michigan-man-dead-hours-after-moderna-mrna-shot/

https://thecovidblog.com/2021/01/19/julie-marie-christensen-mother-of-protective-diet-director-dies-suddenly-after-covid-19-vaccine/

The Elderly Receiving the COVID-19 Vaccine are Dropping Like Flies https://greatmountainpublishing.com/2021/01/24/the-elderly-receiving-the-covid-19-vaccine-are-dropping-like-flies/

7 Dead and 100% of Residents Infected in Spanish Nursing Home After Being Injected with Experimental Pfizer mRNA COVID Shots https://healthimpactnews.com/2021/7-dead-and-100-of-residents-infected-in-spanish-nursing-home-after-being-injected-with-experimental-pfizer-mrna-covid-shots/

24 Dead and 137 Infected at NY Nursing Home After Experimental COVID Injections https://healthimpactnews.com/2021/24-dead-and-137-infected-at-ny-nursing-home-after-experimental-covid-injections/

22 deaths at Pemberley House Care Home After Patients Receive COVID Vaccine https://www.dailyecho.co.uk/news/19043944.amp/

2 Men Dead at Senior Care Home following Experimental Pfizer COVID Injections as Australia Begins COVID Shots https://healthimpactnews.com/2021/2-men-dead-at-senior-care-home-following-experimental-pfizer-covid-injections-as-australia-begins-covid-shots/

24 Residents Dead in 3 Weeks as One Third of UK Nursing Home Residents Die After Experimental mRNA COVID Injections https://healthimpactnews.com/2021/24-residents-dead-in-3-weeks-as-one-third-of-uk-nursing-home-residents-die-after-experimental-mrna-covid-injections/

22 Elderly with Dementia Dead in 1 Week After the Experimental mRNA COVID Injection in the Netherlands https://healthimpactnews.com/2021/22-elderly-with-dementia-dead-in-1-week-after-the-experimental-mrna-covid-injection-in-the-netherlands/

Death of Elderly Swede After Coronavirus Vaccination Referred for Possible Investigation https://www.breitbart.com/europe/2021/01/01/death-of-elderly-swede-after-coronavirus-vaccination-referred-for-possible-investigation

46 Nursing Home Residents in Spain Die Within 1 Month of Getting Pfizer COVID Vaccine https://childrenshealthdefense.org/defender/nursing-home-residents-spain-die-pfizer-covid-vaccine/

8 of 31 Residents Dead in German Nursing Home After They Were Forcibly Injected with Pfizer Experimental mRNA COVID Shots Against Their Will https://healthimpactnews.com/2021/whistleblower-8-of-31-residents-dead-in-german-nursing-home-after-they-were-forcibly-injected-with-pfizer-experimental-mrna-covid-shots-against-their-will/

12 Residents Die After First COVID Vaccine in Wales Nursing and Dementia Care Centre https://healthimpactnews.com/2021/12-residents-die-after-first-covid-vaccine-in-wales-nursing-and-dementia-care-centre/

Two Nuns Dead and 28 COVID Positive 2 Days After Experimental COVID mRNA Injections https://healthimpactnews.com/2021/two-nuns-dead-28-covid-positive-2-days-after-experimental-covid-mrna-injections/

460 Dead 243,612 Reported Injuries from COVID19 Vaccines Reported in the U.K. https://healthimpactnews.com/2021/460-dead-243612-reported-injuries-from-covid-19-vaccines-reported-in-the-u-k/

329 Deaths + 9,516 Other Injuries Reported Following COVID Vaccine, Latest CDC Data Show https://childrenshealthdefense.org/defender/329-deaths-9516-other-injuries-reported-following-covid-vaccine-cdc/

CDC WITHOLDING INFORMATION! 1,170 DEAD Following COVID Injections: Almost Twice as Many Deaths as Found in VAERS https://healthimpactnews.com/2021/cdc-witholding-information-1170-dead-following-covid-injections-almost-twice-as-many-deaths-as-found-in-vaers/

Healthy 43-Year-Old Man Suffers Stroke From Blood Clot Hours After Receiving J&J Vaccine https://childrenshealthdefense.org/defender/healthy-man-stroke-johnson-johnson-vaccine/

At least 13 Israelis have experienced facial paralysis after being administered the Pfizer Covid-19 vaccine https://www.rt.com/news/512736-israel-facial-paralysis-13-covid-vaccine/

27-year-old mother suffers seizures, is hospitalized after taking COVID vaccine https://www.lifesitenews.com/news/27-year-old-mother-suffers-seizures-is-hospitalized-after-taking-covid-vaccine

After Ridiculing Vaccine Skeptics, German Man Develops Severe Paralysis From COVID Vaccination https://christiansfortruth.com/after-ridiculing-vaccine-skeptics-german-man-develops-severe-paralysis-from-covid-vaccination/

Pregnant doctor celebrates taking COVID vaccine, tragically miscarries days later https://www.lifesitenews.com/news/pregnant-doctor-celebrates-taking-covid-vaccine-tragically-miscarries-days-later

Pediatric Nurse Brags About Getting COVID Vaccine While Pregnant – Baby is Stillborn 8 Days Later https://vaccineimpact.com/2021/pediatric-nurse-brags-about-getting-covid-vaccine-while-pregnant-baby-is-stillborn-8-days-later/

 

 

Whistleblower Reveals Many Pregnancy Complications following Experimental COVID Injections – “Vaccine Leaving a Trail of Devastated Mothers” https://healthimpactnews.com/2021/whistleblower-reveals-many-pregnancy-complications-following-experimental-covid-injections-vaccine-leaving-a-trail-of-devastated-mothers/

Wisconsin Resident Doctor has Miscarriage 3 Days After Being Injected with Experimental COVID mRNA Shot https://healthimpactnews.com/2021/wisconsin-resident-doctor-has-miscarriage-3-days-after-being-injected-with-experimental-covid-mrna-shot/

Number of Women in the U.K. Who Have Lost Baby as a Result of COVID Vaccine Doubles in Just 7 Days: MHRA Data Shows https://www.globalresearch.ca/women-lost-baby-result-covid-jab-doubles-7-days-mhra-data-shows/5739323

UK: 35 people deaf and 25 blind after taking mRNA vaccine shots https://www.lifesitenews.com/news/uk-35-people-deaf-and-25-blind-after-taking-mrna-vaccine-shots

Entire School District In Ohio Cancels Classes After Too Many School Staff Have Negative Reactions To The Experimental COVID MRNA Injections https://humansarefree.com/2021/02/entire-school-district-in-ohio-cancels-classes-after-too-many-school-staff-have-negative-reactions-to-the-experimental-covid-mrna-injections.html

 

Bell’s palsy following COVID-19 vaccination https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897359/

Facebook posts provide evidence of link between COVID vaccinations and deaths https://www.lifesitenews.com/news/facebook-posts-provide-evidence-of-link-between-covid-vaccinations-and-deaths

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The following information comes from this website

Below is a list of documented deaths within a week after receiving the Covid vaccine. The list is made up of officially documented cases during an 8 week period. (December 2020 till end of January 2021) The CDC has taken down the VAERS section multiple times during the past period. Each case is documented by healthcare workers. Keep in mind that by far not all cases are being reported.

Each case starts with the patient ID following the report and ends with e.g. : 12/23/2020 (=vax date) 12/24/2020 ( =Date when Adverse effect start) 83 (age) F (sex) DIED ON 12/26/2020

Source: Vaxpain

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 hypo-tension, 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

958565 Clients wife reported on 1/18/2021, that her husband died unexpectedly the day after receiving the COVID 19 vaccine. I called and spoke with her. She stated that the client had started experienced some tightness in his chest the evening of 1/11/2021. She stated that it was normal for him to have the tightness in his chest if he got stressed. She stated that she found him on the garage floor on 1/12/2021 at 2120. He was taken by ambulance to the hospital. She stated that the hospital told her that his COPD had caused him to go into arrythmia. 01/11/2021 01/11/2021 71 M DIED ON 01/12/2021

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

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

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

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

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

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

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

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

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

965547 resident coded and expired; This is a spontaneous report from a non-contactable consumer via Pfizer Sponsored Program. A 63-year-old male patient received the 1st dose of bnt162b2 (BNT162B2, Lot # EH9899) intramuscular at single dose at left arm on 28Dec2020 for Covid-19 immunisation. Medical history included no current Illness, no known allergies, but preexisting conditions: dysphagia, violent behaviors, depressive disorder, schizophrenia, aspiration, gastrooesophageal reflux disease (GERD), hyperlipidaemia, bipolar disorder, rectal bleeding, hypertension. The patient had no birth defect. Concomitant medication included asa (ASA) at 81mg, lisinopril (LISINOPRIL) at 10mg daily, ferrous sulfate (FERROUS SULFATE) at 325 (unit unknown), olanzapine (ZYPREXA) at 20mg, morniflumate (FLOMAX [MORNIFLUMATE]) at 0.4 (unit unknown), famotidine (FAMOTIDINE) at 20mg, ascorbic acid (VIT C), carbamazepine (CARBAMAZEPINE) at 250mg bid, valproate semisodium (DEPAKOTE) at 750mg bid, metformin (METFORMIN) at 1000 (unit unknown) bid, sertraline (SERTRALINE) at 100 (unit unknown) bid, albuterol [salbutamol] (ALBUTEROL [SALBUTAMOL]), buspirone hydrochloride (BUSPAR) at 10mg tid, polycarbophil calcium (FIBERCON). The patient died on 29Dec2020. The patient had no ER or Doctor visit and was not hospitalized. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: resident coded and expired 12/28/2020 12/29/2020 M DIED ON 12/29/2020

965548 passed away; This is a spontaneous report from non-contactable consumers received via a Pfizer-sponsored program An 88-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot EL0142) via an unspecified route of administration on 30Dec2020 at a single dose (1 dose) in the left arm (LA) (administered by: senior living) as Covid vaccine. Medical history included patient was 14 plus days post COVID and unresponsive. The patient had no listed allergies. Concomitant medications were not reported. The patient passed away with an hour and half of receiving vaccine on 30Dec2020. Per nursing staff, they did not expect the patient to make it many more days. She was unresponsive in the room when shot was given. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: passed away 12/30/2020 12/30/2020 88 F DIED ON 12/30/2020

965561 respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a 12/23/2020 12/26/2020 63 F DIED ON 12/26/2020

965564 Cardiac arrest Narrative: 01/14/2021 01/20/2021 58 M DIED ON 01/20/2021

965571 1/13/21 pt came into clinic for vaccine. Had difficulty remembering age. Called me Mon. 1/18/21 stating she was sick. When asked what her sx were, she stated fatigue. She was well the night of the shot, Thur. and Fri. but became tired on Sat. and Sun. I went through other sx with her such as h/a, fever, n/v, muscle aches, weakness and she said she experienced none of those. I questioned her about eating and drinking and she said she ate and drank water. She seemed fine so I told her to call her doctor if she was worse or the fatigue persisted or call 911. She agreed. Two staff from clinic called her Mon. and Tues, (1/18 and 1/19). On Tues. she may have had sl slurred speech. She was found deceased on 01/13/2021 01/20/2021 83 F DIED ON 01/20/2021

965831 Patient received her first dose of vaccine on Monday, January 18th. Two days later on Wednesday, January 18th, she retired to bed early. Later that night when her husband went to bed, he found her in the bed deceased. No other details of the event are know. 01/18/2021 01/20/2021 74 F DIED ON 01/20/2021

965860 Patient had increased SOB while at home. EMS was called. Patient coded in the squad 01/21/2021 01/21/2021 84 M DIED ON 01/21/2021

965910 The employee found dead at her home on 1/21/2021. 01/11/2021 01/22/2021 53 F DIED ON 01/01/2021

965922 We were alerted that the patient died at home. 01/19/2021 01/22/2021 75 M DIED ON 01/22/2021

966178 Pt called son to let him know he couldn’t breath around 2 AM. Pts son showed up at his house 10 minutes later and ambulance arrived with in 20 minutes at 2:15 01/19/2021 01/22/2021 89 M DIED ON 01/22/2021

966359 Headache, pain in the injection site, threw up. A few hours later she died. 01/19/2021 01/20/2021 77 F DIED ON 01/20/2021

966844 Patient is reported to have died at home, the day after his COVID test. Family member states that he did good the afternoon and evening after his COVID-19 injection, but that he started not feeling good the next day. The patient “was having palpitations”. The family tried to convince him to go to the Emergency Room, but he refused. Patient died at home. 01/13/2021 01/14/2021 76 M DIED ON 01/14/2021

966888 At 04:30 on 1/22/2021, facility was notified of employee death at home. 01/22/2021 01/22/2021 56 F DIED ON 01/22/2021

967506 Died within 5 days of receiving vaccine. Exact cause and day unknown. 01/16/2021 01/01/2021 73 M DIED ON 01/21/2021

967743 Possible seizer, unknown at this time, aprox 1hr and 20min after vac given. Passed away aprox 2hrs after vac. 01/19/2021 01/19/2021 77 M DIED ON 01/19/2021

967747 Pt passed away evening of 1/13 – unknown reason currently Narrative: 01/13/2021 01/13/2021 73 M DIED ON 01/13/2021

967749 Cardiac Arrest Narrative: 01/12/2021 01/13/2021 83 M DIED ON 01/13/2021

967830 Patient was was brought to the ED from facility which he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started. Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color. Code was the result of PEA secondary to hypoxia ( 01/21/2021 01/21/2021 64 M DIED ON 01/21/2021 968195 My dad got the Moderna Vaccine on Tuesday, January 12, 2021 in his left arm at the Mall injection site for the Health Department. He was told that the side effects could mean his arm hurting, tiredness, headache, and even a low grade fever. Additionally, the site informed us both (as I was with him to get the injection) that this was all normal and not to seek medical attention unless these symptoms last longer than 72 hours. That evening, my dad was experiencing all of those symptoms, and went to bed at 7pm. A little after 10am on Wednesday, January 13, 2021, when he awoke, my dad went to the bathroom vomiting. This was where he collapsed and went into cardiac arrest. Fire/Rescue was dispatched about 10:30am after my mom started CPR. County Fire Rescue EMTs and Paramedics continued CPR and other attempts at reviving him all the way to Hospital Emergency Department. He was pronounced dead at 12:14pm on Wednesday, January 13, 2021. We have no doubt my dad, following the instructions of the injection facility, thought he was just experiencing the side effects of the vaccine. He had no chance. Had this injection been done in the RIGHT arm, perhaps he could have recognized the arm numbness being that of an impending heart attack. We really miss Dad. He served this country with distinction for over 50 years, and we believe his country failed him. 01/12/2021 01/12/2021 82 M DIED ON 01/13/2021

968707 My mother died 12 hours after the vaccine was administered 01/19/2021 01/19/2021 91 F DIED ON 01/19/2021

968846 Within 15 minutes of the injection, the individual became aphasia and stroke like symptoms. She was taken to the ER where she was later diagnosed with a cerebral hemorrhage and passed away. 01/22/2021 01/22/2021 81 F DIED ON 01/24/2021 969219 patient received the Moderna Covid 19 vaccine on 1/23/2021 around 5:45pm wife called management today and reported that he had collapsed and passed away today around noon 01/23/2021 01/24/2021 61 M DIED ON 01/24/2021

969220 Patient expired one week after vaccine. Cause of death unknown to me. 01/15/2021 01/22/2021 65 F DIED ON 01/22/2021

969363 Patient obtained initial dose of Moderna vaccine on Thurday, Jan 14. No adverse effects reported during initial 15 minute post vaccine waiting period. Saturday morning (Jan 16), patient developed severe cough, labored breathing, and fever. Additionally patient mental status changed suddenly, became non-communicative (unable to speak, but would scream if she was touched). O2 status was irregular, dropping to 78. Sunday morning, EMT and then hospice was hospice called. Monday morning, after hospice emergency kit was initiated, patient passed away. 01/14/2021 01/16/2021 79 F DIED ON 01/18/2021

969488 Fatigue, muscle aches, vomiting, hematoma 01/11/2021 01/11/2021 90 F DIED ON 01/18/2021

969636 Found dead at home slumped on the floor; Loss of appetite; Body aches; Feverish; A spontaneous report was received from a physician, concerning a 65-years-old male patient, who received Moderna’s COVID-19 Vaccine and experienced feverish, body aches, loss of appetite, and death. The patient’s medical history, as provided by the reporter, included diabetes, hypertension, Hashimoto’s, smoker, cataracts, atrioventricular block, occasional premature ventricular contractions, and hypertriglyceridemia. Concomitant medications reported included metformin, glimepiride, lisinopril, atorvastatin, aspirin, methimazole, propranolol, and cilostazol. On 05 Jan 2021, prior to the onset of events, the patient received the first of two planned doses of mRNA-1273 (lot number 037k20a) for COVID-19 infection prophylaxis. On an unknown date in Jan 2021, some time after receiving the vaccine, the patient was feeling feverish with body aches and loss of appetite. On 09 Jan 2021 at approximately 21:30, the patient was found dead at home slumped on the floor. According to the paramedics, the patient was dead longer than when his wife found him, and no resuscitation was performed. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of the events, feverish, body aches, loss of appetite, was considered resolved. The patient died on 09 Jan 2021. The cause of death was not reported. The reporter assessed the event, death, as not related to Moderna’s COVID-19 Vaccine. The reporter did not provide assessment for the events, feverish and body aches, in relation to Moderna’s COVID-19 Vaccine.; Reporter’s Comments: This case concerns a 65 year old male patient with medical history of diabetes, hypertension, Hashimoto’s, smoker, cataracts, atrioventricular block, occasional premature ventricular contractions, and hypertriglyceridemia, who experienced the serious unexpected event of death, non-serious unexpected event of loss of appetite, and non-serious expected events of fever and body pain. The event of death occurred 5 days after the first dose of mRNA-1273. The events of fever, body pain and loss of appetite occurred an unspecified period of time after the first dose of mRNA-1273. Very limited information regarding these events has been provided at this time. Based on temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Definitive causal association is confounded by age and medical history of diabetes, hypertension, Hashimoto’s, smoker, cataracts, atrioventricular block, occasional premature ventricular contractions, and hypertriglyceridemia. 01/05/2021 01/01/2021 65 M DIED ON 01/09/2021

969648 death of unknown cause; Swelling on Right side of the neck and under chin; Warmth on right side of neck and under chin; Redness on right side of neck and under chin; A spontaneous report was received from a healthcare professional concerning an 89-year-old, female patient who received Moderna’s COVID-19 vaccine (mRNA-1273) and experienced events of redness, warmth and swelling on right side of neck and under chin, and death of unknown cause. The patient’s medical history included Alzheimer’s and chronic obstructive pulmonary disease (COPD). No concomitant medications were reported. On 29 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: Unknown) intramuscularly for prophylaxis of COVID-19 infection. On 30 Dec 2020, the patient experienced the events of redness, warmth and swelling on right side of neck and under chin. There was no indication that the patient was transferred out to hospital, which was unlikely because she was under hospice care. On 01 Jan 2021, the patient died due to an unknown cause of death. Action taken with mRNA-1273 in response to the events was not applicable. The patient died on 01 Jan 2020. The cause of death was not provided. Plans for an autopsy were not provided.; Reporter’s Comments: This case concerns a 89-year-old, female subject with a medical history of Alzheimer’s and chronic obstructive pulmonary disease (COPD) who experienced redness, warmth and swelling on R side of neck and under chin and expired from an unknown cause. The events of redness, warmth and swelling on R side of neck and under chin occurred 2 days after administration of the first and only dose of the mRNA-1273 vaccine and patient expired 4 days after mRNA-1273 vaccine administration. Lot # of the vaccine was not provided. De-challenge and re-challenge are not applicable. The events of redness, warmth and swelling on R side of neck and under chin are temporarily associated with the administration of the mRNA-1273 and thus, a causal relationship cannot be excluded. Due to limited information, the fatal outcome was considered unrelated to mRNA-1273 administration pending additional information. Fatal outcome is confounded by the patient’s underlying condition and advanced age.; Reported Cause(s) of Death: Unknown cause of death 12/29/2020 12/30/2020 F DIED ON 01/01/2021

969699 Patient died. 01/19/2021 01/19/2021 83 M DIED ON 01/20/2021

970042 patient passed away with in 90 minutes of getting vaccine; This is a spontaneous report from three non-contactable consumer reporting on behalf of the patient via a Pfizer sponsored program, Corporate (Pfizer) Social Media Platforms. A 90 (unspecified unit) old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, lot number: EL0142, unknown expiration), via an unspecified route of administration in right arm (reported as AR) on 30Dec2020 at a single dose for COVID-19 immunization. The patient’s medical history and concomitant medications were not reported. It was reported that the patient was a nursing home patient and received the first dose of COVID vaccine on 30Dec2020. The patient was monitored for 15 minutes after getting shot. Staff reported that the patient was 15 days post COVID. The patient passed away with in 90 minutes of getting vaccine on 30Dec2020. The patient did not require office/ ER visit. An autopsy was not performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Patient passed away with in 90 minutes of getting vaccine 12/30/2020 12/30/2020 F DIED ON 12/30/2020

970043 Reported causes of death: Diarrhoea; This is a spontaneous report from a contactable healthcare professional via agency and a non-contactable consumer via a Pfizer-sponsored program Corporate (Pfizer) Social Media Platforms. An elderly patient of an unspecified age (also reported as were in their early to mid-60’s) and gender received BNT162B2 (Pfizer-BIONTECH Covid-19 Vaccine), via an unspecified route of administration on 10Dec2020 at a single dose for COVID-19 immunisation. Medical history included pseudomembranous colitis (broad), gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), and noninfectious diarrhoea (narrow) . The patient’s concomitant medications were not reported. The patient experienced diarrhoea on an unspecified date in 2020. It was reported that most of the deaths after the COVID-19 vaccine occurred within 24-48 hours after the shot. The write-ups that accompanied the reports furnished details about these sad fatalities, including the astonishing fact that some of the decreased had actually experienced and recovered from COVID-19 (raising questions about why they were vaccinated). It was also reported that the event was not life-threatening, did not result to a birth defect or permanent disability, did not require any office/ER/doctor visit, and did not require any hospitalization. The patient died on 10Dec2020. It was not reported if an autopsy was performed. The reported cause of death: diarrhoea. No follow up attempts are possible, information about the lot/batch number cannot be obtained.; Sender’s Comments: Based on the available information the event diarrhea resulting in death is attributed to patients preexisting medical conditions including pseudomembranous colitis, gastrointestinal nonspecific symptoms and therapeutic procedures, and noninfectious diarrhea. However, based on a close chronological association (same day) contributory role of BNT162B2 (Pfizer-BIONTECH Covid-19 Vaccine) to event exacerbation 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: Reported causes of death: Diarrhoea 12/10/2020 01/22/2021 U DIED ON 12/10/2020

970044 reported causes of death :circulatory collapse; asystole; reported causes of death :circulatory collapse; asystole; This is a spontaneous report from a Pfizer-sponsored program received from the Regulatory Authority-WEB GB-MHRA-WEBCOVID-20201214111558, satety Report unique Identifier GB-MHRA-ADR 24542972 and EU-EC-10007191566 received via Regulatory Authority 908245. A contactable pharmacist and three consumers reported that an adult female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 13Dec2020 at a single dose for COVID-19 vaccination. The patient’s medical history was not reported. Concomitant medications included acetylsalicylic acid, amiloride HCl, allopurinol, desogestrel, furosemide, levothyroxine, sildenafil, and spironolactone. The patient experienced circulatory collapse and asystole on 13Dec2020. The patient died due to asystole and circulatory collapse on 13Dec2020. It was unknown if an autopsy was performed. No follow-up attempts are possible, information about lot/batch number cannot be obtained. No further information Is expected.; Sender’s Comments: The information available is limited and does not allow a meaningful case evaluation. However, based solely on a close chronological association (same day) a causal relationship between events circulatory collapse and cardiac arrest and BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) cannot be completely excluded. The case will be reevaluated should additional information become available. 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: reported causes of death :circulatory collapse; asystole; reported causes of death :circulatory collapse; asystole 12/13/2020 12/13/2020 F DIED ON 12/13/2020

970139 arrested/heart was at a standstill; brief seizure; Last blood glucose was 167; feeling poorly; This is a spontaneous report from a contactable pharmacist. A 66-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: EL1283), intramuscularly in the left arm, on 15Jan2021 at 14:00 (at the age of 66-years-old) at a single dose for COVID-19 immunization. Medical history included congestive heart failure presented with unresponsiveness, coronary artery disease, dyslipidemia, hypertension, non-ongoing stroke (no residuals) in 2001, thyroid disorder, walnuts allergies, stenting to left anterior descending artery (LAD) and right coronary artery (RCA), wheezing, chest pain, and erectile dysfunction. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medication, taken within two weeks of vaccination, included salbutamol (PROVENTIL) taken for wheezing, salbutamol (VENTOLIN) taken for wheezing, acetylsalicylic acid (ASPIRIN 81), colecalciferol (reported as Vitamin D3; MANUFACTURER UNKNOWN), furosemide (LASIX) taken for weight gain, glyceryl trinitrate (reported as: nitroglycerin; NITROSTAT) taken for chest pain, hydrochlorothiazide (HYDRODIURIL), levothyroxine sodium (SYNTHROID), levothyroxine sodium (LEVOTHROID), metoprolol succinate (TOPROL XL), montelukast sodium (SINGULAIR), prasugrel hydrochloride (EFFIENT), rosuvastatin calcium (CRESTOR), sildenafil (VIAGRA) taken for erectile dysfunction, spironolactone (ALDACTONE), and testosterone (ANDROGEL). It was unknown if patient received other vaccines within four weeks of vaccination. The patient experienced feeling poorly on 15Jan2021 at 14:50 and patient arrested/heart was at a standstill, brief seizure, and last blood glucose was 167 on 15Jan2021 at 15:15. The patient expired on 15Jan2021 at 15:15. The clinical course was reported as follows: The patient received the vaccine on 15Jan2021 around 14:00 and started feeling poorly around 14:50. The patient arrested after a brief seizure. Cardiopulmonary resuscitation (CPR) was initiated by his wife. Emergency medical service (EMS) arrived around 15:21 and initiated advanced cardiovascular life support (ACLS). CPR was continued upon arrival. A bedside ultrasound was performed and revealed his heart was at a standstill on 15Jan2021 and last blood glucose was 167 on 15Jan2021. Therapeutic measures were taken as a result of the events as aforementioned. The clinical outcome of expired and arrested/heart was at a standstill was fatal and of feeling poorly, brief seizure, and last blood glucose was 167 was not recovered. The patient died on 15Jan2021. The cause of death was assessed as arrested/heart was at a standstill. It was not reported if an autopsy was performed. It was also reported that since the vaccination, the patient had not been tested for COVID-19.; Sender’s Comments: The 66-year-old male patient had medical history included congestive heart failure presented with unresponsiveness, coronary artery disease, dyslipidemia, hypertension, stroke, thyroid disorder, stenting to left anterior descending artery (LAD) and right coronary artery (RCA), wheezing, chest pain. The reported fatal event cardiac arrest was most likely due to concurrent cardiac diseases, and unlikely causally related to the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE). The case will be reassessed should additional information become available. 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: arrested/heart was at a standstill 01/15/2021 01/15/2021 66 M DIED ON 01/15/2021

970412 Fever Feeling tired short of breath all night and morning after the vaccine My grandma had to be intubated and then passed away to a heart distress we think it was the vaccine because she was fine even with dialysis. When she got the vaccine it took hours and her health conditions changed. 01/18/2021 01/18/2021 79 F DIED ON 01/22/2021

970495 Patient expired three days after receiving first dose of Moderna COVID-19 vaccine. The death certificate states cause of death is sudden cardiac arrest. 01/13/2021 01/16/2021 77 F DIED ON 01/16/2021

970618 SON SAID PATIENT WAS FOUND UNRESPONSIVE AND CALLED 911 01/22/2021 01/23/2021 89 F DIED ON 01/25/2021

970976 At approximately 12:15 pm the resident had a brief unresponsive episode that resolved quickly. Her Vital signs were stable and her mentation was at baseline. Later that evening approximately 10 pm she had labored respirations, shortness of breath, lethargy with bilateral crackles, Oxygen desaturated to 76% on room air, tachycardia and hypotension. She expired at 6:30 a.m. the following day. 01/20/2021 01/20/2021 95 F DIED ON 01/21/2021

971176 Pt. woke up the next morning after vaccination and “didn’t feel well”, described by wife as fatigue, no energy. At approximately 2 PM, he vomited. His wife checked on him at 4:20 PM and he wasn’t breathing sitting in his chair. EMS squad was called but when they arrived he was asystole and mottling present. Did not start CPR since he was already gone too long. Pronounced by coroner on scene. 01/20/2021 01/21/2021 84 M DIED ON 01/21/2021

971561 Unspecified event/he passed away; Dizziness; Nausea; Headache; This is a spontaneous report from a contactable consumer (patient’s wife). An 80-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Lot number EL3302), intramuscular at single dose in the left arm on 20Jan2021 08:15AM for Covid-19 immunisation. Medical history included atrial fibrillation (Diagnosed about 10 years ago). Concomitant medications included unspecified drug for atrial fibrillation. On 20Jan2021, the patient experienced dizziness, nausea, headache with outcome of unknown and unspecified event/he passed away. The patient died on 20Jan2021. An autopsy was not performed. The events were described as follows: “Her husband received the first dose of the vaccine yesterday morning and he passed away last night. She is not sure what time he died last night. States he was so eager to get the vaccine. Reports he was exhibiting symptoms that were listed as possible side effects. He was experiencing dizziness, nausea, and a headache that started several hours after the vaccine, the side effects started in the early afternoon. She does not know the cause of death and does not think an autopsy was performed”. The vaccine was administered at Hospital Facility. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine.; Reported Cause(s) of Death: Unspecified event/he passed away 01/20/2021 01/20/2021 80 M DIED ON 01/20/2021

971736 Vomit 30 minutes after administration. approx. 9 hours later, resident has Stroke-like symptoms. He was previously on Hospice before admitting to our facility and planned to be readmitted to hospice upon discharge. 01/21/2021 01/21/2021 88 M DIED ON 01/21/2021

971813 patient received vaccine on 1/20/2121, later that night husband found her slumped in chair, called EMS and patient was taken to Hospital where she died on 1/21/2021 01/20/2021 01/20/2021 85 F DIED ON 01/21/2021

971969 brought by EMS to ED; seizures at home in bed; 6 Epi and 1 bicarb; no hx of seizure 01/15/2021 01/21/2021 72 F DIED ON 01/21/2021

972092 Reportedly, this employee’s mother died the night of the vaccine. The details are not known at this time. 01/19/2021 01/19/2021 88 F DIED ON 01/19/2021

972113 Resident became lethargic and reports of blood coming from resident’s nose and mouth on the morning of 1/13/21. Resident went out to ER for eval, and came back to facility with dx of pneumonia and recommendations for resident to be placed on hospice. Resident deceased on 1/14/21. Unknown if vaccine related, but with timeline of events I was advised to report this per medical director of facility, as well as Pharmacy who administered the vaccine. 01/12/2021 01/13/2021 91 F DIED ON 01/14/2021

972370 patient received covid vaccine and had a heart attack the next day and died 01/20/2021 01/21/2021 60 M DIED ON 01/21/2021

972394 Died about 24 hours later 01/19/2021 01/20/2021 65 M DIED ON 01/20/2021

972610 Patient was tested positive for Covid-19 on 12/9/20. Patient received Covid Vaccine on 1/21/21. Patient was observing for 15 minutes in treatment room by Nursing staff. Patient denied any signs/symptoms adverse effect: headache, dizziness & weakness, difficulty breathing, muscle pain, chills, nausea and vomiting, and fever . Patient seated on treatment table appeared to be relaxed, respiration even and unlabored. Health teaching provided. Patient educated to report any changes in condition to staff immediately. Patient verbalized understanding and able to verbalize signs and symptoms and adverse effects to be aware of related vaccine. On 1/22/21: patient was seen by medical provider for “altered behavior”. Per medical provider’s documentation: “Patient was fallen on 1/2/21 and was sent out to outside hospital on 1/4/21. CT head: no intracranial abnormality, age-related changes. Patient had labs (B12, RPR, folate) were within normal limit”. We did MMSE today: 22/30 score “mild dementia” On 1/23/20: “Patient was inside his cell. He was walking towards cell door to obtain his breakfast, when custody witnessed him collapse and activated the alarm. Nursing staff arrived at cell front at 06:34 am and found the patient pulseless and unresponsive, and CPR was immediately initiated. AED was attached at 06:35 am and no shock advised. AMR then arrived and patient did not have ROSC, and was pronounced dead at 06:54 am.” 01/21/2021 01/23/2021 65 M DIED ON 01/23/2021

972782 Resident expired on 1/23/21 . Resident receiving care under hospice ,diagnosis Acute Myeloid Leukemia. 01/18/2021 01/23/2021 81 F DIED ON 01/23/2021

972836 sudden death 01/20/2021 01/24/2021 88 F DIED ON 01/24/2021

973814 DEATH Narrative: 01/12/2021 01/12/2021 95 M DIED ON 01/14/2021

973957 5 days after receiving his COVID vaccination the patient had a spontaneous (nontraumatic) subarachnoid hemorrhage which was fatal. The patient had previously been stable on his coumadin dosing with therapeutic INRs for the past several months per his wife. At time of presentation his blood pressure in the ER was elevated to 223/94 and his INR was risen to 3.1 01/20/2021 01/24/2021 81 M DIED ON 01/26/2021

974172 Resident passed away 1/25/2021 at 1048pm after the vaccine was given on 1/24/2021. Resident had been being monitored but death was not expected. 01/24/2021 01/25/2021 94 F DIED ON 01/25/2021

974422 Patient developed fever to 102 within 24 hours with decreased mentation. Stopped eating/drinking despite aggressively treating fever. Was DNR B status. Family agreed to a trial of IV fluids on 1/21 but was not successfully started until 1/22 after several attempts. Family wanted only comfort measures with no transfer to hospital. Patient continued to have fevers to 102-103 range. Patient passed on 1/23 . Patient did test positive for COVID in early September without significant illness. She was in usual state of health prior to vaccination. 01/18/2021 01/19/2021 85 F DIED ON 01/23/2021

974443 Patient received Moderna COVID vaccine on 12/30/2020 at a Pharmacy clinic where he was a resident. Nurses at the facility reported that he was responsive and showed no signs of any adverse effects until 1/2/2021 when he was observed slightly unresponsive and staring at the ceiling and trembling. He had a fever of 101F at this time. The facility ordered labs and a rapid COVID test (all of which came back normal) and started IV antibiotics. A few hours later, patient began bleeding from his eyes, nose, and mouth and was sent to the local ER. The patient refused being admitted to the ICU for possible sepsis/hemorrhage and died the following day on 1/3/2021. All healthcare professionals involved agreed that this was not likely due to the vaccine, but needed to be reported nonetheless. 12/30/2020 01/02/2021 76 M DIED ON 01/03/2021

974489 No immediate symptoms. No symptoms ever reported. Patient was found dead in her home on 1/25/2021 and last seen on 1/24/2021. Neighbor called for welfare check because they had not seen her and she had not checked mailbox. No evidence of foul play. 01/19/2021 01/25/2021 80 F DIED ON 01/25/2021

974833 1/24/21 0445- patient presents to the ED with complaints of neck pain, chest pain, and back pain for about a week. States also feels SOB, intermittent fever with temperature 100.3 on arrival. Patient was worked up for his cardiac type symptoms, found to have elevated WBC and CRP with no explanation. D-Dimer was elevated with CT showing no sign of PE. Patient was sent home from the ED with instructions to follow up with primary care and/or return if s/s worsen. 1/24/21 1705- patient is returned to the ED via ambulance after becoming unresponsive and some seizure like activity. Patient was intubated. Head CT showed large brain bleed that was irreparable and not compatible with life. Patient was also found with positive blood cultures x2 with gram positive cocci in clusters growing after 9 hours. 01/19/2021 01/24/2021 85 M DIED ON 01/25/2021

974855 decedent had shortness of breath and hypoxia, cardiac arrested in front of the EMS crew, ACLS initiated, arrived in the Hospital ED asystole and pronounced dead 01/25/2021 01/25/2021 76 F DIED ON 01/25/2021

975002 on 1/13/2021 at 3:40am Cliff called for assistance. He lost his balance and had fallen. Cliff refused vitals, refused emergency department, denied hitting his head. As the day progressed patient developed a headache, diarrhea, and vomiting. He again declined the offer for the emergency room. At supper time wife and staff found Cliff unresponsive, 911 was called and he was taken to the emergency department. The ER did a CT scan and found an acute subdural hematoma. Patient was placed on comfort cares and expired at 3pm on 01/14/2021. Cliff did not have a history of falls. 01/12/2021 01/13/2021 88 M DIED ON 01/14/2021

975023 CARDIAC ARREST THAT LEAD TO DEATH – IT WAS REPORTED BY EMS THAT THE PT HAD RECEIVED THE VACCINE ABOUT 30 MINS PRIOR. HE ARRIVED HOME, BECAME SHORT OF BREATH & COLLAPSED. 911 WAS CALLED AND HE WAS TRANSPORTED VIA EMS TO HOSPITAL (16:17) WHERE HE LATER EXPIRED (23:01). 01/25/2021 01/25/2021 76 M DIED ON 01/25/2021

975184 The patient had a heart attack and died at a local hospital morning of 1/19/2021. 01/14/2021 01/19/2021 89 F DIED ON 01/19/2021

975382 01/22/20When transferring resident from bed to W/C Resident became unresponsive to voice with eyes fix open and point up to the right. Placed resident back in bed found 82% o2 sats B/P 110/106 pulse 110 resp below 16 placed o2 via non rebreather with 20 l/min 02 up to 90% then stabilized at 89% Resident following all commands encouraged to take do breathing exercises, with some compliance, continues ABT/pneumonia , no s/s adverse 1/23/2021 16:48 Discharge Summary Note Text: Resident found unresponsive with no pulse or respirations in bed with emesis on gown. Time of death verified at 1645 with LPN. Funeral Home called at 1900 and body released at 2000. 01/20/2021 01/22/2021 83 M DIED ON 01/23/2021

975421 Resident was discovered deceased in his apartment on 1/23/2021. Family had 01/07/2021 01/01/2021 60 M DIED ON 01/01/2021

975434 vomiting x3 1/8/21 1/9/21 00:34 – called to resident room by CNAs, staff stated resident was “different”. Vitals taken and 02 sat was low, O2 in room and applied via NC @3L, O2 sat returned to 98 and all other vitals WNL including BS. Resident asked how he felt, stated he felt “okay”. Resident exhibiting some shakey movements and clearing throat, states he does not have any phlegm or drainage or trouble swallowing. MD called and updated on situation, voicemail left. 1/9/21 11am- resident has been making a “growling” noise this shift. resident also has tremors. resident alert and answers questions appropriately. when asked if resident wants to go to hospital, resident firmly states “no”. vitals wnl. no emesis noted. will continue to monitor resident. 1/9/21 12p- resident not answering questions appropriately. resident only answering yes or no. resident cannot tell me name, or the year, resident cannot state where he is currently or birthdate. 01/02/2021 01/07/2021 67 M DIED ON 01/09/2021

975762 Pt deceased 01/20/2021 01/24/2021 57 F DIED ON 01/24/2021

975918 death Narrative: 01/12/2021 01/17/2021 61 M DIED ON 01/17/2021

975952 Narrative: 01/15/2021 01/16/2021 92 M DIED ON 01/18/2021

976032 Patient stated he wasn’t feeling well on January 25, 2021, wasn’t eating and complained of abdominal pain. Patient noted to have indigestion and was constipated. Meds provided and labs ordered. On morning of January 26, 2021, patient became weak, lethargic and hypoxic and was sent to emergency department around 0700 hours on January 26, 2021. At approximately 1100 hours, emergency physician notified this writer that patient was not going to overcome his illness and would be placed on comfort care. At approximately 1130 hours, this writer was notified that patient had passed away from multi-organ failure. 01/22/2021 01/26/2021 92 M DIED ON 01/26/2021

976111 CC:full arrest HPI:HPI and ROS limited due to patient’s condition. History is via EMS, medical record, and son. Per Son patient had Covid vaccine on Saturday morning. Slept all day Sunday. Woke up Sunday night a bit “like coming out of a deep sleep per son, around 10 pm. Shortly after that patient was having a hard time breathing. Emergency called. Arrested around the time EMS arrived. King airway, I/O and CPR initiated. Patient has been in v fib. Was shocked multiple times, given 4 rounds of epi, bicarb and amiodarone. ACLS continued on arrival. Multiple rounds of epi, and attempted defib. Patient given epi, bicarb. Rhythms included fine v fib, asystole, and PEA. Unrecoverable with no cardiac motion. Time of death 11:50 pm. 01/23/2021 01/24/2021 84 M DIED ON 01/24/2021

977320 about 20+ hours after vaccination resident was having hard time breathing, 911 was called. Resident coded multiple times at the facility after CPR she was taken to ICU. She coded again and was placed on life support. Due to her choice to not be on life support she passed on 11/26/2021. 01/25/2021 01/26/2021 83 F DIED ON 01/26/2021

977426 Patient has a history of advanced melanoma with brain metastasis. He developed seizure disorder as well and had some mild seizures at home over the prior month. He received the vaccine at 4pm and was monitored in the office for 15 minutes. He then went home with his daughter whom he lives with. He ate dinner with her and read until 8pm when he went to his room. She found him in his room at 9pm unresponsive with seizures. Hospice was alerted and recommend oral valium. He continued to be unresponsive and expired the following day at 7:30 pm. 01/20/2021 01/20/2021 70 M DIED ON 01/21/2021

977963 (Report per patients wife ) Patient took his usual nap around 12pm. She found him lying in the bed unresponsvie at 2pm. EMS was not called. Patient’s wife called the Funeral home. 01/26/2021 01/26/2021 81 M DIED ON 01/26/2021

978199 Arm hurting used his oxygen at time of bed appeared vomited. 01/06/2021 01/07/2021 71 M DIED ON 01/07/2021

978754 No symptoms appeared immediately after vaccination, although patient passed away around 6:00 pm unexpectedly. Staff talked with her last time at 5:30 pm and then found her at 6:00 pm passed away. Unknown at this time if death is directly related to receiving the vaccine. 01/26/2021 01/26/2021 93 F DIED ON 01/26/2021

978872 died suddenly at night; This is a spontaneous report from a contactable consumer. A 72-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, on 15Jan2021 (at the age of 72-years-old) as single dose for COVID-19 immunization. Medical history included myasthenia gravis, hypertension (well controlled), non-ongoing major back surgery on an unspecified date (4 months ago), and deep vein thromboses (DVTs) (cleared by ultrasound after therapy). The patient was not pregnant at the time of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient had no allergies to medications, food, or other products. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications, taken within two weeks of vaccination, included pyridostigmine bromide (MESTINON), prednisone (MANUFACTURER UNKNOWN), tramadol (MANUFACTURER UNKNOWN), paracetamol (TYLENOL), hydrochlorothiazide, lisinopril (MANUFACTURER UNKNOWN), and rivaroxaban (XARELTO). The patient died suddenly at night on 21Jan2021 at 02:00. It was reported that the patient was not sick or showing any symptoms before bed on 20Jan2021 at 21:00 and reported feeling fine after getting the vaccine. The patient did not receive any treatment for the event. The patient died on 21Jan2021. The cause of death was unknown. An autopsy was not performed. It was also reported that since the vaccination, the patient had not been tested for COVID-19. The batch/lot number for the vaccine, BNT162B2, was provided and has been requested during follow up.; Reported Cause(s) of Death: died suddenly at night 01/15/2021 01/21/2021 72 F DIED ON 01/21/2021

979081 Patient found dead in home the next morning. May or may not be connected to vaccination. Instructed to report it from our medical director and director of nursing. 01/21/2021 01/22/2021 89 M DIED ON 01/22/2021

979101 cardiac arrest – no warning signs 01/22/2021 01/25/2021 64 F DIED ON 01/25/2021

979255 Patient received COVID 19 vaccine the morning of 1/18/21 at Public Health COVID-19 vaccine clinic. I (person completing this report) work for PH. Later that night while in bed, patient reported difficulty breathing to his wife, then turned blue, and became unresponsive. Family report pt was without any symptoms prior to event. 911 called; CPR started by family member 15 min. after pt became unresponsive. EMS performed resuscitation for about 30-40 minutes with multiple defibrillation for V-fib. Between EMS and Medical Center ER, pt had 9 rounds of epi, CPR w/ LUCAS machine, given 2 doses of amiodarone (150 mg and 300 mg). Patient had 3 EKGs, which did not show STEMI, but did show nonspecific conduction delay and sinus arrest with junctional escape vs sinus bradycardia (HR 50’s). Pt had return of spontaneous circulation. Pt intubated, and started on Levophed. Pt transferred to ICU, and had central line placed. Family decided to make patient DNR. Pt went into coarse VFib again, and as per wishes of family, code blue not called. Patient expired at 01:53 on 1/19/21. 01/18/2021 01/18/2021 65 M DIED ON 01/19/2021

979533 Patient recieved vaccine 1 of covid 19 i 1/19/2021. She felt poorly on 1/20/2021. She felt dizzy and fell at 3 AM on 1/23/2021. She felt poorly and did not know her son’s name which was not normal. She went to ER on 1/24. She was assessed as not having fractures. She was going to be transferred to a skilled nursing facility. She was not having respiratory complaints. She was awaiting transfer when her O2 levels started dropping substantially. She declined aggressive intervention and she died within a few hours. 01/19/2021 01/20/2021 82 F DIED ON 01/25/2021

979818 Patient arrived at ER with complaints of CPR in progress. Per EMS, patient became short of breath while performing yard work on 1/26/2021. At arrival, patient was in fine v fib with a total of 6 shocks delivered along with 300 mg amiodarone followed by 150 mg amiodarone, 1 amp epinephrine and 2 epinephrine drips adminstered en route to ED. CPR initiated at 1755 and EMS reports asystole at 1829. TOD 1909 pronounced by ED DO Dx: Cardiac arrest 01/25/2021 01/26/2021 77 M DIED ON 01/26/2021

979837 Per EMS, the patient was last seen walking and talking to wife 10 minutes prior to EMS arrival. EMS reports via patients wife, that patient was upstairs to change for his doctor appointment then patient’s wife found him down. The patient received his COVID-19 vaccine on 1/25/21. EMS states they gave 5 rounds of EPI then patient moved into vfib then was shocked once but returned to asystole. In ED, the patient initially in asystole CPR was started immediately. The patient was given 3 rounds EPI, 1 round bicarb. The patient stayed in PEA throughout. Patient was given tPA. Patient continued to be in asystole and time of death was called at 11:35 am. 01/25/2021 01/27/2021 76 M DIED ON 01/27/2021

979926 Pt began experiencing shortness of breath 3 days after vaccine and expired later that day. 12/30/2020 01/02/2021 81 F DIED ON 01/02/2021

979990 sudden cardiac arrest 01/07/2021 01/09/2021 63 M DIED ON 01/09/2021

980107 Patient noted to have a change in status at 11:23PM that night. Her oxygen saturation had dropped from normal on room air to 82% and required oxygen. She was also noted to be lethargic with altered mental status and not responding verbally. She then began to mottle. Her oxygen saturation worsened to 51% on 4Liters of oxygen by the next day and she expired on 1/14/21. 01/12/2021 01/12/2021 90 F DIED ON 01/14/2021

981061 Patient died 3 days post Moderna vaccine. 01/22/2021 01/25/2021 87 F DIED ON 01/25/2021

981225 Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally. At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive without a pulse. 01/27/2021 01/27/2021 59 F DIED ON 01/27/2021

981406 Stroke, death 01/15/2021 01/18/2021 71 F DIED ON 01/18/2021

981849 died 01/16/2021 01/13/2021 01/16/2021 92 M DIED ON 01/16/2021

981912 Patient presented to the Emergency Department complaining of chest pain, pale, cool diaphoretic, and hypotensive. The patient was discovered to have a large saddle pulmonary embolism, went into cardiac arrest and expired. Of note, the patient received her second Moderna COVID vaccine on 1/23, which would place her first one approximately 12/25 if she received them at the appropriate interval. This information is from the patient’s daughter and the ED record, the information is not available in CAIR. Per the daughter, the patient started feeling ill on 1/21, improved on 1/25, and then acutely worsened on 1/27, resulting in the ED visit. 01/23/2021 01/23/2021 67 F DIED ON 01/27/2021

981938 UNKNOWN/ASYTOLE Narrative: Please refer to section 6. 68y/o male with h/o severe peripheral vascular disease with previous left AKA 2/3/20, s/p bilateral bypasses in the past. Pt recently underwent right AKA on 1/12/21. Per Hospital remote data 1/10/21 pt c/o shortness of breath, CXR demonstrated right lower lobe opacity & left basilar infiltrate. Pt s/p >10 days emperic IV abx. Moderna vaccine 0.5ml IM was administered via left deltoid on 1/22/21 around 16:21. On 1/23/21@05:14 code blue was called as pt found to be unresponsive, breathless and pulseless, facial cyanosis noted, CPR started immediately.Pt found to be in asystole. ACLS guideline followed but no return of spontaneous circulation, At 05:32 pt remained pulseless and breathless and was pronounced. Autopsy currently pending. 01/22/2021 01/23/2021 69 M DIED ON 01/23/2021

982218 resident was on hospice, chronically ill w dementia, COPD, HTN, failure to thrive, passed away 1/13/21. Not certain injection related as he was declining already. 01/08/2021 01/13/2021 63 M DIED ON 01/13/2021

982370 Patient died at hospital on j/16/2021 approximately 48 after receiving vaccination. Believe death related to fall at home prior to vaccination. 01/14/2021 01/16/2021 93 M DIED ON 01/16/2021

982541 36 hours after vaccination, the patient had increased respiratory distress. He was placed on high flow nasal cannula oxygen with mild improvement. He then continued to be hypotensive requiring IV fluids and subsequently IV vasopressors. Patient’s BP was stabilized with vasopresor, however he continued to deteriorate clinically with altered mental status and lethargy, concerned for bowel peroration based on physical exam by MD. He was then emergency intubated and placed on mechanical ventilation. He was then transferred to acute care hospital near by. 01/22/2021 01/24/2021 81 M DIED ON 01/25/2021

982826 Was at work on 1/26/21 and collapsed, no known complaints a the time. CRP was initiated immediately, transported to ER and pronounced dead 01/21/2021 01/26/2021 40 M DIED ON 01/26/2021

982890 Pt presented to ER via EMS at 1556 3 days after receiving vaccine. pt was breathing approximately 50 times a minutes and o2 sats in the 70’s upon arrival. NP decided to intubate, Rocuronium and Versed given. Pt became bradycardic and 1 amp of Atropine was given without improvement. No pulse felt, CPR started per ACLS protocol. 7 Epi’s given. Time of death- 1632. After TOD pt was swabbed for COVID-19 and the results were positive. 01/22/2021 01/25/2021 67 M DIED ON 01/25/2021

982942 per recipient spouse – vaccine recipient became ill during the night of 1/21/21 or early morning of 1/22/21 and was deceased in the morning of 1/22/21. 01/21/2021 01/21/2021 57 M DIED ON 01/22/2021

983169 Client received the COVID-19 vaccine on 1/5/21 by the Vaccine clinic. Plans were for Hospice services. Client tested positive for COVID-19 by rapid testing on 1/8/21. On 1/10/21 at 0900 Client was unresponsive and without vital signs. Orders were for DNR, and CPR was not initiated. 01/05/2021 01/08/2021 83 M DIED ON 01/10/2021

983482 per daughter pt suffered a stroke 1 hour after he was given the covid vaccination. he passed away on 01/24/2021. 01/20/2021 01/20/2021 90 M DIED ON 01/24/2021

984617 Patient passed su hospital on 23Jan2021 stopped breathing; complained of not feeling well; had an inflamed gall bladder; This is a spontaneous report from a contactable consumer. A 98-year-old female patient received bnt162b2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL8982 and expiry date unknown), via an unspecified route of administration on 16Jan2021 at single dose for covid-19 immunisation. The patient medical history was not reported. The patient concomitant medication reported as has received other medications (unspecified) within 2 weeks. The patient passed in hospital on 23Jan2021 with stopped breathing. Day after vaccine on 17Jan2021, the patient complained of not feeling well, went to hospital where was told she had an inflamed gall bladder. The events caused patient hospitalization for 4 days. The cause of death reported as stopped breathing. It was unknown if autopsy done. Prior to vaccination, the patient not diagnosed with COVID-19. The outcome of the event breathing arrested was fatal, outcome of the other events was unknown.; Reported Cause(s) of Death: Stopped breathing 01/16/2021 01/17/2021 98 F DIED ON 01/23/2021

985205 Patient was feeling dizzy and under the weather after the vaccination. The following day he died in his sleep during a nap. 01/25/2021 01/26/2021 75 M DIED ON 01/26/2021

985449 Patient was an 87 y/o female admitted for septic shock. She was started on and eventually maxed on 3 pressors. CT abd showed colonic obstruction with dilatation of large and small bowel. Patient was made DNR in the ED. Palliative care consulted on case. Family opted for comfort care. Patient was asystole on monitor. No spontaneous breath/cardiac sounds ausculted. Patient did not withdraw to pain. Pupils fixed and dilated. She was pronounced and 1230 on 1/28/21 01/27/2021 01/28/2021 87 F DIED ON 01/28/2021

985715 Patient received the vaccine on 12/29/20 and presented at the ER at the Hospital on 12/30/20 stating that he wasn’t feeling well. It is stated that his health had declined over the past few weeks and currently on hospice. Visit was unremarkable. Patient stated that wanted to stop dialysis. Patient passed away on 01/02/2021. 12/29/2020 01/02/2021 80 M DIED ON 01/02/2021

985814 started having generalized weakness on 1/21/21, fatigued., nausea/vomiting. went to doctor on 1/25/21 with complaint of sore throat, cough, and felt congested. Went to ER on 1/25/21 with complaints of increased shortness of breath, worsening nausea and vomiting. started on oxygen for sats of 87%. admitted on 1/25/21. On 1/26/21 needed intubated, CXR showed worsening consolidative change right lung at right hilar level. Echocardiogram showed ejection fraction 35-40%, left atrium is moderately dilated. 01/20/2021 01/21/2021 94 M DIED ON 01/26/2021

985933 Died; Increased respirations (22 and labored at times); Pulse 105; 94% O2 on RA; Labored breathing at times; leukocytosis; elevated BUN; left lower lung congestion; elevated creatinine; Temperature of 102.0F; Redness on face; A spontaneous report was received from a nurse concerning a 92-year-old, female patient who received Moderna’s COVID-19 vaccine (mRNA-1273) and experienced redness on face, increased respirations, labored breathing at times, temperature of 102F, pulse of 105, 94 percent O2, leukocytosis, elevated BUN, left lower lung congestion, elevated creatinine, and death. The patient’s medical history, as provided by the reporter, included dementia and reduced mobility. No relevant concomitant medications were reported. On 29 Dec 2020, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 30 Dec 2020, the patient began to experience redness on her face, increased respirations (reported as 22 and labored at times), pulse of 105, and 94 percent oxygen saturation on room air. The patient had a fever of 102 degrees Fahrenheit. Laboratory tests revealed a negative influenza swab, elevated white blood cell count of 14.1, elevated BUN at 113, and creatinine 2.7. Chest x-ray showed mild, left lower lung infiltrate. On 31 Dec 2020, the patient went under hospice care per her family request.. Action taken with mRNA-1273 in response to the events was not applicable. The patient died on 01 Jan 2021, the cause of death was unknown.; Reporter’s Comments: This case concerns a 92-year-old, female subject with medical history of dementia and reduced mobility, who experienced the serious unexpected events of death, respiratory rate increased, heart rate increased, oxygen saturation decreased, elevated BUN, elevated creatinine, left lung congestion and dyspnoea and the non-serious events of erythema and pyrexia. The events of respiratory rate increased, heart rate increased, oxygen saturation decreased, dyspnoea, erythema and pyrexia occurred 2 days after the first dose of the study medication administration, and the event of death occurred 4 days after the first dose of the study medication administration. Very limited information regarding the events is available at this time and no definite diagnosis or autopsy report have been provided. Additional information has been requested.; Reported Cause(s) of Death: Died 12/29/2020 12/30/2020 F DIED ON 01/01/2021

986063 Resident was vaccinated on 1/13/21. Resident passed away on 1/16/21 01/12/2021 01/16/2021 83 F DIED ON 01/16/2021

986123 passed away-heart attack; This is a spontaneous report from a contactable consumer, the daughter of the patient from a Pfizer Sponsored program Pfizer First Connect. A male patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), via an unspecified route of administration on 19Jan2021 as a single dose for COVID-19 immunization. The patient’s medical history and concomitant medications were not reported. On 24Jan2021, the patient passed away due to a heart attack. It was not reported if an autopsy was performed. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Reported Cause(s) of Death: passed away-heart attack 01/19/2021 01/24/2021 M DIED ON 01/24/2021

986857 Extreme bouts of nausea first few days after vaccine. Estimated that patient died at home within 3-4 days after receiving the vaccine. Last phone call to daughter expressed extreme nausea and seemed to have altered mental status. Found dead by daughter on 01/04/2021. 12/28/2020 12/28/2020 66 M DIED ON 01/04/2021

986869 Patient noted with respiratory distress on 1/10/2021, transferred to hospital via 911. 01/03/2021 01/10/2021 79 F DIED ON 01/01/2021

986901 Patient received vaccine uneventfully with no acute concerns. Left clinic and by report went out with friends. Spoke to father on phone at or around 9:00 pm. Failed to show up to work and was found dead at home. Other details pending 01/28/2021 01/28/2021 33 F DIED ON 01/29/2021

986948 Cardiac arrest on 1/24/21 in the early morning hours then passed away on 1/25/21 around 1:51am in the hospital 01/22/2021 01/24/2021 80 F DIED ON 01/25/2021

987029 Resident passed away at 8:15 am on 1/28/21-found to be without pulse/respirations/DNR order in place. 01/27/2021 01/28/2021 86 M DIED ON 01/28/2021

987126 Patient died. Patient had been declining in health rapidly prior to receiving the vaccine 01/29/2021 01/29/2021 90 F DIED ON 01/29/2021

987301 My Mother was given the Covid Vaccine (1st Dose) on 12/28/2020. Later that night we received a call from the nursing facility that my Mother was having uncontrollable seizures and had to be transported to the nearby hospital. The ER doctor confirmed that my Mother had tested positive to Covid. She was treated for Covid and was on life support. A few days later we received a call that my Mother had a major stroke. She passed away on January 4, 2021 12/28/2020 12/28/2020 87 F DIED ON 01/04/2021

987469 emesis bright yellow in color, liquid BM, increased respirations 01/26/2021 01/27/2021 89 M DIED ON 01/28/2021

987513 Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt’s condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified. 01/27/2021 01/27/2021 64 M DIED ON 01/28/2021

987533 The patient was observed to be lethargic on 1/29/21 at 1515. BP-80/50, P-75, RR-27, T-100.1. He was given a bolus of NS 150 mlx2. and Rocephin 1 gram IM. 01/28/2021 01/29/2021 91 M DIED ON 01/29/2021

987789 REC’D CALL FROM PT’S DAUGHTER, HER FATHER WAS VACCINATED ON 1/22/21, WOKE UP 1/23/21 WAS SHORT OF BREATH AND DIZZY. PT PRESENTED TO ED OF LOCAL HOSPITAL AND WAS ADMITTED, PT PASSED ON 1/25/21. DAUGHTER STATES THAT FAMILY AND DOCTORS AGREE THAT THE VACCINE DID NOT CONTRIBUTE TOWARDS PT’S DEATH, BUT FELT IT NEEDED TO BE REPORTED. PT’S DAUGHTER CONTACTED THIS RN AT LOCAL HEALTH DEPARTMENT TO REPORT TO VAERS. 01/22/2021 01/23/2021 85 M DIED ON 01/25/2021

988245 93 y/o with complex medical history (severe COPD on oxygen, diastolic CHF, CKD3, myelofibrosis, marginal zone lymphoma of spleen with recent progression and no active treatment, chronic anemia, afib, CAD, pulmonary artery hypertension, h/o bladder cancer, hypertension, hypothyroidism, h/o bilateral PE, sick sinus syndrome s/p pacemaker, h/o Hodgkin’s disease). Has had multiple hospitalizations over the last 3 months for dyspnea, most recently in 12/2020. Enrolled in palliative care. Has had multiple transfusions (most recently 01/13/21) for his chronic anemia due to myelofibrosis, and recently started on darbepoetin. No documented history of anaphylaxis to medications or prior vaccinations. He received COVID19 vaccine (Moderna) on 01/16/21. He passed away suddenly at home on 01/17/21. Symptoms: & cardiac arrest Treatment: 01/16/2021 01/17/2021 93 M DIED ON 01/17/2021

988369 aspiration pneumonia/death 01/19/2021 01/21/2021 82 M DIED ON 01/22/2021

989006 After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing. EMS was called as I made my way outside. Upon my arrival patient was leaning out of the car and stating that she could not breath. She was able to tell me that she was allergic to penicillin. Oxygen was immediately placed on the patient with minimal relief. Lung sounds were coarse throughout. She then began to vomit about every 20-30 seconds. Epipen was administered in the right leg with no relief. Patient continued to complain of troubles breathing and vomiting. A second epipen was administered in the patients right arm again with no relief. A few minutes later patient was given racemic epinephrine through the oxygen mask. There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting. When EMS arrived patient was unable to transport herself to the stretcher. When EMS and clinical staff transferred patient to the stretcher she became unresponsive. She appeared to still be breathing. She did not respond to verbal stimuli. Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance. When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned. At that time patient was found to be in PEA, shock was delivered. Shortly thereafter no cardiac activity was found and patient pronounced dead. 01/30/2021 01/30/2021 58 F DIED ON 01/30/2021

989015 Myocardial Infarction 01/26/2021 01/27/2021 69 M DIED ON 01/27/2021

990780 patient passed 01/25/2021 01/28/2021 75 M DIED ON 01/28/2021

991060 Fever 101.1, unresponsive episode. Transferred to Hospital on 1/28. Diagnosis there was anemia and CHF, aware that he had vaccine day prior. Transfused with 2 units pRBC’s. Transferred back to Nursing Home on 1/30 and passed away 0140 1/31/2021 01/27/2021 01/28/2021 88 M DIED ON 01/31/2021

991216 Vaccine given on 01-25-2021. Wife reported on 01-29-2021 that patient had a ran a fever on 01-26-2021, Was better on 01-27-2021. She found him dead when she came home work on the evening of 01-28-2021. 01/26/2021 01/28/2021 70 M DIED ON 01/28/2021

991622 Death 01/28/2021 01/29/2021 90 F DIED ON 01/29/2021

991849 Congestion, Hypoxia, SOB, Tachycardia, Weakness. Started on O2 @ 3L, HOB elevated, Tylenol supp 01/25/2021 01/27/2021 88 M DIED ON 01/28/2021

991859 Per granddaughter’s report, pt became very weak within hours of receiving the first dose of the Moderna COVID-19 vaccine and could not get out of bed the next morning without assistance, reported difficulty seeing, and did not recognize some family members. By Sunday, 1/31, pt was unable to be awakened, would not eat, and had low urinary output. Granddaughter reports that the morning of 2/1 he was awake and ate a small amount and seemed to be improving although still weak and unable to get out of bed. Granddaughter reported he died 2/1 around 10am in the morning. 01/29/2021 01/29/2021 89 M DIED ON 02/01/2021

991927 Patient was found deceased at Nursing Home in his room 01/12/2021 at 5:25 AM. 01/05/2021 01/12/2021 86 M DIED ON 01/12/2021

991997 Resident c/o nausea evening of 1/29 (nausea common for her post dialysis), had a large emesis at approx 2220, 0030 (unusual for resident to vomit)- received Zofran per order. Skin cool and damp, Blood sugar 147 (checked due to h/o diabetes and poor intake). At approx 230am Blood pressured checked and noted to be 52/29. Resident transferred to ER, intubated and transferred to higher level of care where she passed away on 1/30 at 736pm. Resident’s medical notes indicated likely shock, cardiogenic in nature, sepsis (source unknown) along with a multitude of other co-morbidities that resident has. 01/28/2021 01/30/2021 71 F DIED ON 01/30/2021

992082 Resident was noted on 1/25 with an increased functional decline as she would not feed herself with utensils, but would eat finger foods if placed in her hand. She was started on Rocephin IM for possible infections. Labs had been obtained on 1/21/21, unremarkable for CBC and CMP. 75,000 colony count on urine. On 1/26/21 she was noted with right sided weakness and further decline. She was sent to Hospital for further evaluation. We were notified that she expired on 1/28/2021. Resident had been noted with a decline in function about 2 weeks earlier when she would not stand or transfer any longer. She was still responsive, taking meds, and feeding herself until 1/26/21. Further information on admitting diagnoses and progress notes from hospital have not been available to date. 01/24/2021 01/25/2021 70 F DIED ON 01/28/2021

992237 1/28/2021- Seen by FNP for indigestion, chest pressure and palpitations. EKG reviewed and referral made to Cardiology. 1/29/2021-1800 Presented to ED in cardiac arrest-onset PTA. Patient was found unresponsive by his wife at their home. The last known well was at 1530 when she called him on the phone. The patient was pronounced at ~1850. 01/25/2021 01/29/2021 42 M DIED ON 01/29/2021

992347 Death 02/01/2021 02/01/2021 78 M DIED ON 02/01/2021

992571 Patient’s wife called the physician’s office with increasing SOB. MD advised that the patient go to the ED. While dressing, the patient became unresponsive, 911 called. Patient expired in ED. 01/29/2021 01/30/2021 75 M DIED ON 01/30/2021

992599 right arm redness 12/31/2020 01/03/2021 87 F DIED ON 01/03/2021

992677 Low Grade Temp, Persistent low back pain, Projectile Vomiting. 01/25/2021 01/26/2021 64 M DIED ON 01/29/2021

992846 Patient complained to wife of not feeling well in evening after the vaccination and expired at home during the night. 01/29/2021 01/29/2021 82 M DIED ON 01/29/2021

992884 The next morning after vaccine, patient ran a fever, vomited, and was very tired. Mom laid her down to sleep and when she checked later, patient had passed away. 01/16/2021 01/17/2021 57 F DIED ON 01/17/2021

992977 spoke with patient husband on Saturday 1/23 and he said that she had been in the hospital. that she had had a stroke, the MD’s at the hospital told him that it was not contributed to the vaccine and that they were unsure even if the stroke had occurred prior to the vaccine or after. spoke with him again on 1-29 and he stated that she had passed away on 1/25/21 01/20/2021 01/20/2021 84 F DIED ON 01/25/2021

993028 On 1/9/21-Diaphoresis, O2 90%, respirations 22, increased weakness, wheezing bilaterally. Send to ER for evaluation and treatment. She was sent to ER, where she was admitted for 2 days, then expired there on 1/11/21 01/06/2021 01/09/2021 78 F DIED ON 01/11/2021

993072 Pt. presented to the ER with abd pain and septic shock. Pt. reported to feel ill shortly after receiving the vaccine. 01/27/2021 01/27/2021 64 F DIED ON 01/31/2021

993828 Heart stopped; Could not swallow; This is a spontaneous report from a contactable nurse (patient’s wife). An 85-year-old male patient received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 21Jan2021 at a single dose for COVID-19 immunization. Medical history included blood pressure abnormal (verbatim: blood pressure) from an unknown date and unknown if ongoing, neuropathy from an unknown date and unknown if ongoing, weight issue from an unknown date and unknown if ongoing, diabetes from an unknown date and unknown if ongoing, walker user from an unknown date and unknown if ongoing. Concomitant medications included insulin aspart (NOVOLOG) taken for diabetes from an unspecified date to an unspecified date; and he was taking a long acting one as well. The patient previously received the influenza vaccine (MANUFACTURER UNKNOWN) for immunization on unknown dates (“had flu shots before with no reactions and everything, nothing before”). On 24Jan2021, the patient’s heart stopped (death, medically significant), and could not swallow (medically significant). The clinical course was reported as follows: The patient’s wife stated the patient was taking insulin aspart (NOVOLOG) and he was taking a long acting one as well. The reporter, the patient’s wife and a retired registered nurse (RN) stated, her husband (patient) just died and she thought he died from the COVID vaccine (later clarified the reason of death was-heart stopped). The patient had the vaccine on 21Jan2021, which was on a Thursday, and he was fine. On the following Sunday around 1:30 (on 24Jan2021), the patient was feeling a little weak, however, the patient’s wife thought maybe his blood sugar was low. The patient’s wife checked, and the patient’s blood sugar was 91. The patient’s wife went to get some yogurt to feed him in order to get his blood sugar up a little; “which was a normal thing for him, it was not that low for him.” Then, suddenly, the patient fell, and the patient’s wife could not get a pulse or anything. The patient’s wife called an unspecified number and she started compressions; however, he was dead. The patient’s wife stated the patient just had his heart test, a three hour long one, and it was “perfect three weeks ago.” The patient had just gone to the doctor the other day and his blood pressure was “fine and everything.” The patient’s wife stated that other than his diabetes, “which he had for (sentence incomplete).” Regarding lab tests, the patient’s wife stated, “No, he had it before but not in the last two weeks. He was going for one because we just went to the doctor last week and he was going to call yesterday to make the appointment request to get his blood work done. Blood work has been good except his A1C was always high, but other than that everything was good” (as reported). Regarding causality, the patient’s wife stated, “I do, because he was fine until about half an hour before he died. He said to me, I feel a little weak today and then I was talking to him that your upper body strength is really good and then I said, we just have to work on your weight a little more because he did have neuropathy. And then, I went out of the room and all of a sudden I just heard him fall and that is when I just went in to check his blood sugar and it was 91 and I got him yogurt and he started eating that and then that was it, he started spitting it out and he said, I could not swallow and that was it, he just died.” The patient’s wife further added, “I just wanted other people to know that things like this happen and I am sure it was from that because he was healthy as could be. He was walking with his walker, the day before outside and he felt fine.” The clinical outcome of the event, heart stopped, was fatal. The clinical outcome of the event, could not swallow, was unknown. The patient died on 24Jan2021 due to “heart stopped.” 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: Heart stopped 01/21/2021 01/24/2021 85 M DIED ON 01/24/2021

993998 passed away; cough; This is a spontaneous report from a contactable consumer, the patient’s daughter. A 92-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), via an unspecified route of administration in the left arm on 13Jan2021 at 11:00 (at the age of 92-years-old) as a single dose for COVID-19 immunization. Ongoing medical history included nursing home resident, admitted to hospice on 13Jan2021 (prior to vaccination), and oxygen supplementation (due to low oxygen levels) from a few days prior to the vaccine (Jan2021). Other relevant medical history included congestive heart failure from Dec2020 and sulfa allergy. Prior to the vaccination, the patient was tested numerous times (as reported) for COVID-19 and was negative. There were no concomitant medications. The patient did not receive any other vaccines within four weeks prior to the vaccination. A few days before the vaccination, her oxygen level had gone down, and she had been placed on oxygen. Prior to receiving the vaccine, the patient was reported as being ‘fine’. On 13Jan2021, the patient received the vaccine at 11:00. The patient coughed maybe 5 or 6 times and then dropped her head. Resuscitation was not performed as patient had a do not resuscitate (DNR) order. The patient passed away on 13Jan2021 at 13:05. The cause of death was not reported. An autopsy was not performed. The clinical outcome of the cough was unknown at the time of death. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Reported Cause(s) of Death: passed away 01/13/2021 01/13/2021 92 F DIED ON 01/13/2021

994544 The patient went home around 11 am on 1-31-21 after her vaccine and 15 minute observation period. She was eating breakfast after at home and complained to a neighbor that her teeth hurt and she was nauseated after eating. In the afternoon, she felt dizzy and had diarrhea accompanied with blood. Close to 9 PM, her son went to check on her. The patient was found on the floor–she was unresponsive and had purple lips. Her son called an ambulance and started chest compressions. The patient passed away at the hospital. The doctor has ordered an autopsy, and the results are pending. 01/31/2021 01/31/2021 84 F DIED ON 01/31/2021

994788 Patient death on 2/1/2021 at 4:55am at hospital. 01/25/2021 02/01/2021 74 F DIED ON 02/01/2021

994790 Resident found unresponsive in room this am at approx. 9:30 am. Resident was observed eating breakfast around 8:45 am. Housekeeper reported seeing resident between breakfast and time found unresponsive. Resident had voiced no complaints. Code was initiated until EMS arrived and transported resident to hospital. Resident expired. 01/31/2021 02/02/2021 58 F DIED ON 02/02/2021

994913 patient passed away 2 days after vaccine. patient had temperature, nausea, and vomiting after vaccine. 01/30/2021 01/31/2021 48 F DIED ON 02/01/2021

995165 Died in sleep 01/27/2021 01/30/2021 92 F DIED ON 01/30/2021

995224 Cardiac arrest; Pain on her upper right chest; Lot of pain in lower abdomen; Pain underneath arm; Thought it was muscle aches; A spontaneous report was received from a nurse concerning a 92-year-old, female patient who received Moderna’s COVID-19 Vaccine (mRNA-1273) and developed upper right chest pain and underneath the arm, severe abdominal pain, muscle aches and cardiac arrest. The patient’s medical history was not provided Concomitant product use was not provided by the reporter. On 14 Jan 2021, approximately five days prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the arm for prophylaxis of COVID-19 infection. On 19 Jan 2021, the patient developed upper right chest pain and pain underneath the arm. They thought it was muscle aches. Sometime later, the patient developed a lot of pain in the lower abdomen. The called emergency services and an ambulance arrived but the patient then suffered cardiac arrest. Treatment for the event included tramadol. Action taken with mRNA-1273 in response to the events was not applicable due to the patient was died. The patient died on 19 Jan 2021. The cause of death was reported as cardiac arrest. Autopsy were not provided.; Reporter’s Comments: Company Comment: This case concerns a 92-year-old female patient who experienced unexpected serious events of cardiac arrest, upper right chest pain and underneath the arm, severe abdominal pain, muscle aches. The event occurred 5 days after the administration of the first dose of the vaccine mRNA-1273 vaccine (Lot #: unknown, expiration date-unknown). Although a temporal association exist between the events and the administration of the vaccine, in the absence of critical details such as the patient’s medical history, any diagnostic test or autopsy result, adequate evaluation and assessment cannot be established. Main field defaults to ‘possibly related’ for all events.; Reported Cause(s) of Death: Cardiac arrest 01/14/2021 01/19/2021 92 F DIED ON 01/19/2021

995441 The vaccine was given on Monday. Tuesday afternoon he developed weakness in both legs and could not stand up. This was a new development; he had neuropathy in one leg but he had been able to stand up and walk three hours before. He was helped to the bathroom. He said he felt better and might want to stand up again. He was helped to bed. He was found dead around 5:30 Wednesday morning. He was 94 years old and had a lot of medical conditions. No one has indicated his death had anything to do with the vaccine. I’m sure it’s just a coincidence that he died so soon after receiving the vaccine 01/25/2021 01/26/2021 94 M DIED ON 01/27/2021

995649 Cardiac arrest; Patient transported by EMS to hospital 11:00pm on 01/29/2021. Patient received vaccine on 01/25/2021. Patient expired 01/30/2021 within the hour into the new day after midnight on 01/30/2021. Patient was feeling well prior to and any chronic health conditions were well controlled. Sudden cardiac arrest 4 days after receiving the vaccine. Details given by patients husband/POA. 01/25/2021 01/29/2021 79 F DIED ON 01/30/2021

995825 Client unexpectedly collapsed and passed away on 1/13/21 from suspected sudden cardiac death. Prior to her death, she was in skilled care for rehabilitation following hospitalization from 12/21-12/31/20 for an acute lower GI bleed. Her hospitalization and skilled care stay were complicated by delirium and she was being treated for delirium with olanzapine (Zyprexa) at time of death. 01/06/2021 01/13/2021 92 F DIED ON 01/13/2021

996105 patient received vaccine on Jan 23, 2021 passed away on Jan 24, she was already on hospice, so unclear if due to vaccine or other issues. Was at her baseline before and after vaccine per facility, had b’fast and passed away at noon on Jan 24 01/23/2021 01/24/2021 95 F DIED ON 01/24/2021

996156 Client came to nursing station about 2pm to report she “was not feeling well”. Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was “off the charts” and that she had pain covering her whole left side of her body. She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home. 911 was immediately called and authorities took over the scene. 02/01/2021 02/01/2021 58 F DIED ON 02/02/2021

996423 Patient had a CVA and passed away suddenly 1/10/21 01/04/2021 01/10/2021 81 M DIED ON 01/10/2021

996591 patient received vaccine on Jan 23, 2021. developed weakness on Jan 25, 2021. Sent to ED on Jan 27, 2021 with hypoxia requiring 6 L O2, low Bp, declining mental status. Per family request transitioned to hospice and passed away on Jan 30, 2021 01/23/2021 01/25/2021 85 F DIED ON 01/30/2021

997553 fatigue x 5 days, including day of vaccination, death the night of day 5/early morning of day 6 01/26/2021 02/01/2021 92 M DIED ON 02/01/2021

997677 Rapid decline in health status, Elevated BP&P, posturing, loss of consciousness, Glasgow coma Scale 4 starting 2/1/2021, Deceased 2/3/21 02/01/2021 02/01/2021 94 F DIED ON 02/03/2021

997783 patient passed away subsequent to receiving dose on 02/01. Staff does not have reason to believe vaccine was involved. 02/01/2021 02/03/2021 65 M DIED ON 02/03/2021

998138 Same day as vaccination given, developed pain went from arm up to shoulder, to back, to neck to head – right side of body; chills/body aches 01/22/2021 01/22/2021 86 F DIED ON 01/26/2021

998228 Found unresponsive 01/29/2021 02/03/2021 65 M DIED ON 02/03/2021

998576 Had acute respiratory failure, dysuria NSTEMI after Dose #1 Lot # 025L20A (Moderna) hospitalized same day 12/31/20 administered @ 1040 back to baseline. 2nd Dose on 1/27/21 0950 Lot as above. Unknown exact onset same day, ED by EMS @ 1745, respiratory distress, febrile 39.4 degrees C BP 150/105 RR 29 01/27/2021 01/27/2021 86 M DIED ON 01/31/2021

998637 Patient noted to have irregular breathing in bed and unable to arouse. Provided life saving measures in the field x 30 minutes and transferred to hospital. Noted to have heart arrhythmia which suspected to cause cardiac arrest. 01/13/2021 01/15/2021 75 F DIED ON 01/15/2021

998770 Patient had no symptoms or adverse events until the next evening after shot (1/29/21) where daughter reported her having heart palpitations. Family told her to rest and did not seek medical attention. Saturday afternoon (1/30/2021), patient started experiencing labored breathing. Daughter called 911 and before the ambulance arrived, the patient’s breathing became more and more shallow. Patient was taken to the local hospital and passed away Saturday evening around 5:30 pm. 01/28/2021 01/29/2021 91 F DIED ON 01/30/2021

1000228 dead; Collapsed; bnt162b2 was given to patient with immunocompromised w/ reportable conditions; bnt162b2 was given to patient with immunocompromised w/ reportable conditions; This is a spontaneous report from a contactable nurse. A 40-year-old male patient receive first dose of bnt162b2 (Lot number: EK9231, Brand: Pfizer), intramuscular in left arm on 21Jan2021 15:15 at single dose for COVID-19 immunization. Medical history included immunocompromised w/ reportable conditions from an unknown date and unknown if ongoing, positive for Covid in September from Sep2020 to an unknown date. The patient’s concomitant medications were not reported. The patient experienced dead, collapsed on 26Jan2021. Therapeutic measures were taken as a result of collapsed. The outcome of collapsed was unknown. The patient died on 26Jan2021. It was not reported if an autopsy was performed. Received Covid vaccine here on 21Jan2021, was at work on 26Jan2021 and collapsed, no known complaints at the time, CPR (cardiopulmonary resuscitation) was initiated immediately, transported to ER (Emergency room) and pronounced dead. Unknown if other vaccine in four weeks. The patient had COVID prior vaccination. Unknown If COVID tested post vaccination.; Sender’s Comments: Based on the information currently provided, the patient was immunocompromised and had prior COVID infection. The death and syncope more likely are associated with the patient underlying medical conditions. More information such medical history, concomitant medications, treatment indication and event term details especially death cause and autopsy results are needed for fully medical assessment. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Dead 01/21/2021 01/21/2021 40 M DIED ON 01/26/2021

1000665 Death 2 days later; This is a spontaneous report from a contactable Other HCP. A 97-year-old male patient received the 1st dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL0140) via intramuscular in the left arm on 18Jan2021 12:00 PM at single dose for covid-19 immunisation. Medical history included prostate cancer, macular degeneration, type 2 diabetes, atrial fibrillation. No known allergies. Concomitant medications included glipizide, warfarin and metformin in two weeks. The patient had no other vaccine in four weeks. The patient experienced death on 20Jan2021 at 09:00 PM. Death cause was undetermined. No autopsy was performed. No treatment was received for AE. The patient had no covid prior vaccination, no covid tested post vaccination. Outcome of the event was fatal.; Sender’s Comments: Event unknown cause of death is assessed as Related until sufficient information is available to confirm an unrelated cause of death or if there is sufficient information to allow an unrelated causality assessment. Case will be reassessed when follow-up information is received. 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: Death 2 days later 01/18/2021 01/20/2021 97 M DIED ON 01/20/2021

1000669 she died; This is a spontaneous report from a contactable physician. A 33-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Batch/lot number: EL3247, expiration date: 31May2021) via an unspecified route of administration in left deltoid on 28Jan2021 13:20 at single dose for COVID-19 immunization. Medical history included asthma; optic neuritis. Concomitant medication included glatiramer acetate (COPAXONE) for optic neuritis, at the scene there was an injectable for optic neuritis, physician believed it was glatiramer acetate, he did not know the dosage, but it was three times per week. Sixteen hours after receiving the vaccine patient was found dead at her home. The cause of death was unknown. They just knew within 24 hours of receiving the vaccine in her left deltoid she died. Patient did not indicate she had any allergies or co-morbidities. One autopsy had been done, but it was pending. The actual date patient away if it was 28Jan2021 or 29Jan2021 was unknown as well at this time. The physician only knew she was found dead in home 16 hours after getting the vaccine. The physician stated he did not know what that dose was and questioned if it was 0.5ml. At end of call, physician stated he expected someone to call him back so they can determine the relationship of this to the vaccine. There were no additional vaccines administered on the same date of the Pfizer suspect. No vaccinations within 4 weeks. The outcome of the event was fatal.; Sender’s Comments: The causal relationship between BNT162B2and the event death cannot be excluded as the information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. 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: she died 01/28/2021 01/01/2021 33 F DIED ON 01/01/2021

1000670 she was hurting at her chest/ Chest pain; on her left arm hurt real bad that’s what the clot on her left arm; on her left arm hurt real bad that’s what the clot on her left arm; She passed away; heart attack; This is a spontaneous report from a contactable consumer. An 87-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 19Jan2021 at single dose for COVID-19 immunisation. Medical history included diabetes mellitus, for which she was taking a pill like an hour before she would take her meal. On Monday (Jan2021) the patient experienced was hurting at her chest/ chest pain, her left arm hurt real bad as she had a blockage in her left arm/clot on her left arm, and they wanted to put in a stent and after the surgery it went well and she all go home in two days. The patient was hospitalized in Jan2021 due to the events. She had a heart attack and that the chamber between the dividers had a hole in it and her heart tissue was too thin so much thin she couldn’t repair it. The patient passed away on 26Jan2021. The patient was tested negative for COVID-19 on unknown date. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: She passed away 01/19/2021 01/01/2021 87 F DIED ON 01/26/2021

1000856 Myocardial infarction Narrative: PMH significant for aortic valve stenosis, mitral valve stenosis, CKD, CHF, DM, HTN, obesity, hypothyroidism and dyslipidemia. Per report from primary care – the patients wife reports that the patient went on Saturday (1/30/21 – about 1050) morning to receive his COVID vaccine. He returned home and told her about the experience and denied any side effects. He then proceeded to sit in his easy chair for a while and around 1:30, she asked him if he wanted any lunch. The patient’s wife reports he “grumbled” at her, and then got up to go to the bathroom. She then heard a loud crash and found him lying on the floor of the bathroom, with his head knocking hole in the wall as he fell. She could not detect a pulse. She called 911 and began compressions. First responders to the scene likewise tried to revive him but were not successful in her efforts. Per primary care documentation – Uncertain if related to Pfizer vaccine; vaccine administered on 1/30/21 and approximately 3 hours later suffered fatal MI at home. 01/30/2021 01/30/2021 78 M DIED ON 01/30/2021

1001567 Death 02/02/2021 02/03/2021 81 M DIED ON 02/03/2021

1002052 Passed away yesterday, found deceased in her apartment; This spontaneous report was received from a consumer which refers to a 91-year-old female patient who received the Moderna COVID-19 vaccine (mRNA-1273) and next day the patient passed away. The patient’s medical history was not provided. Concomitant medications were not reported. On 19 Jan 2021, the patient received her first of two planned doses of mRNA-1273 intramuscularly (Lot number: not provided) for prophylaxis of COVID-19 infection. On 20 Jan 2021, the patient passed away and she was found deceased in her apartment. No treatment medication was provided. Action taken with mRNA-1273 in response to the events was not applicable as the patient passed away. On 20 Jan 2021, the patient died, cause of death was unknown. Autopsy result was unknown. The reporter assessed the causality as related between the event and Moderna COVID-19 vaccine.; Reporter’s Comments: This case concerns a 91-year old female patient. The medical history and concomitant medication is not provided. The patient experienced Death. The event occurred approximately one day after receiving their first of two planned doses of mRNA-1273 (Lot unknown). Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the onset of the event, a causal relationship cannot be excluded and the event is considered possibly related to the vaccine.; Reported Cause(s) of Death: Unknown Cause of Death 01/19/2021 01/20/2021 F DIED ON 01/20/2021

1002057 Sudden death 02/03/2021 02/04/2021 80 F DIED ON 02/04/2021

1002187 PATIENT WAS IN CLINIC FOR 1ST CLINIC. WAS DISCHARGED BEFORE OUR 2ND CLINIC. HE CAME BACK TO OBTAIN HIS 2ND SHOT. WE WENT OUT TO THE CAR GAVE SHOT. THE NEXT DAY TO MY KNOWLEDGE, HE STARTED CODING AT HOME. AMBULANCE WAS CALLED AND HE CONTINUED TO CODE. THE AMBULANCE CREW TRIED CPR FOR 30 MINS WITH NO LUCK. PATIENT PASSED 2-3-21. 02/02/2021 02/03/2021 77 M DIED ON 02/03/2021

1002255 Death 01/27/2021 01/28/2021 76 F DIED ON 01/28/2021 1002453 No reaction at time of vaccination. Reported by family that pt. died on 1/29/2021. Coroner does not believe this was related to vaccine, but requested to report to VAERs 01/26/2021 01/29/2021 71 F DIED ON 01/29/2021

1002535 On 1/29/21 patient began not feeling well and saw her provider. The doctor gave her fluids and tramadol for pain. They noticed increased confusion, but thought that could have been due to the tramadol. They also increased her gabapentin as she was experiencing nerve pain. Patient also developed a rash and was diagnosed with shingles on 2/1/21. Patient died on 2/3/21 01/28/2021 01/29/2021 97 F DIED ON 02/03/2021

1002813 Patient was seen at 0710 he was sleeping but at normal cognitive behavior Patient was again assessed at 0720 where he was noted to be unresponsive, BP 180/100s, HR 230s, he was a DNR therefore not CPR was administered. EMS arrived at facility patient was noted to be in full cardiac and respiratory arrest. Time of death 0735 02/03/2021 02/04/2021 91 M DIED ON 02/04/2021

1002840 Client lives alone and had dinner at his home with family members after the 4:40 appointment. Client stated that in general he did not feel well but did not give any specific symptom. Family states they asked the client to go to the ER and the client refused. Family states they helped the client to his chair in the living room and then left to go home. Family states that the client was found in his bedroom the next morning at 7:54 a.m. deceased. 01/26/2021 01/27/2021 85 M DIED ON 01/27/2021

1002931 CARDIAC ARREST, DEATH Narrative: The patient presents to the emergency department in cardiopulmonary arrest. CPR was continued upon arrival. The Combi tube was removed and an endotracheal tube was placed without complications. ROSC was obtained multiple times but the patient continued to go into PEA. The patient was seen in the emergency department by both critical care and Cardiology. EKG shows ST elevations, but the patient was unstable to go to catheterization. The patient had 1 episode of asystole. Despite best efforts and multiple attempts we were unable to resuscitate the patient. Time of death 1253 on 1/24/21. 01/21/2021 01/24/2021 77 M DIED ON 01/24/2021

1002937 death Narrative: Pt attended arthritis clinic appt 0900; labs shortly after; rec’d vaccine in clinic ~ 1113; seen on surveillance camera walking to parking garage ~ 1145; medical center rec’d call from wife ~ 1900 that pt never returned home; police found vehicle running in parking garage, code called, pt obviously deceased by that time 1930, body sent to medical examiner for autopsy. 02/01/2021 02/01/2021 73 M DIED ON 02/01/2021

1003106 Resident received vaccination at 9:12 am, she was monitored and checked at the 15 minute interval 9:27 am, reassessed, vitals were fine. Within 20 (9:32 am) minutes of receiving the vaccine she was unresponsive, pupils were fixed at 9:45 am, no vital signs noted; hospice came out and reported her time of death 10:21 am. This person was on hospice. 02/04/2021 02/04/2021 92 F DIED ON 02/04/2021

1003329 Patient’s primary care provider received a death certificate to be signed for this patient. He spoke with the patient’s husband and son, who reported that the patient had pain and swelling at the vaccine administration site after receiving the vaccine and was feeling unwell after receiving the vaccine. The patient’s family reported that they found her unresponsive on 2/2/21 and called 9-1-1. The patient was pronounced dead upon arrival of emergency responders. 01/29/2021 02/02/2021 73 F DIED ON 02/02/2021

1003382 Began with vomiting and diarrhea. C/O chest pain. Bradycardia. Hypotension. 2 seizures in 45 minutes after not having one in years. We gave fluids. Gave Zofran. Comfort measures. Pt passed at midnight. Was completely fine one day before. Had minimal issues with COVID though did have a pneumonia that was treated w ATB early on and resolved. 02/02/2021 02/03/2021 83 F DIED ON 02/04/2021

1003390 On 2/1/2021, the patients daughter, who claims is a nurse, reported this incident to me. She stated that the evening after the patient received the vaccine, she felt some mild injection site pain. The morning after, the patient reported severe abdominal pain, diarrhea and vomiting. The patients daughter then called her physician to report these symptoms and attributed them as an adverse reaction to the vaccine at that time. These symptoms were intermittent for one week and no other adverse reactions were noted. In the early morning hours of 1/27/2021, the patient was toileting and had expired while doing so. An ambulance was called and cause of death was not found. An autopsy was not performed. 01/20/2021 01/21/2021 88 F DIED ON 01/27/2021

1003624 Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911. Send to ED. Febrile 39.2 and hypotensive 58/43. Admitted. unknown after that as patient expired in hospital. 01/25/2021 01/26/2021 58 M DIED ON 01/01/2021