|
VAERS ID: |
1060958 (history) |
Form: |
Version 2.0 |
Age: |
90.0 |
Sex: |
Male |
Location: |
Connecticut |
Vaccinated: |
2021-01-01 |
Onset: |
2021-02-11 |
Days after vaccination: |
41 |
Submitted: |
0000-00-00 |
Entered: |
2021-02-28 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
012L20A / 2 |
RA / SYR |
Administered by: Other Purchased by: ? Symptoms: Condition aggravated, Dementia Alzheimer's type SMQs:, Dementia (narrow) Life Threatening? No Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Atorvastatin 40; trazadone 60; mama tine 10 mg; metoprolol 50 mg Current Illness: Alzheimer?s Preexisting Conditions: Alzheimer?s Allergies: None Diagnostic Lab Data: Nine CDC Split Type: Write-up: Increased Alzheimer''s symptoms |
|
VAERS ID: |
1071195 (history) |
Form: |
Version 2.0 |
Age: |
70.0 |
Sex: |
Female |
Location: |
Unknown |
Vaccinated: |
2021-02-01 |
Onset: |
2021-02-01 |
Days after vaccination: |
0 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-03 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / 2 |
LA / SYR |
Administered by: Public Purchased by: ? Symptoms: Condition aggravated, Dementia Alzheimer's type, Mental status changes SMQs:, Dementia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad) Life Threatening? No Birth Defect? No Died? No Permanent Disability? Yes Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: rivastigmine and memematine Current Illness: none Preexisting Conditions: Alzheimer''s Allergies: penicillin Diagnostic Lab Data: CDC Split Type: Write-up: Mental state has changed since second dose. Alzheimer''s symptoms have become very noticeably worse since second dose of Moderna Covid vaccine. |
|
VAERS ID: |
1114448 (history) |
Form: |
Version 2.0 |
Age: |
84.0 |
Sex: |
Male |
Location: |
Puerto Rico |
Vaccinated: |
2021-01-25 |
Onset: |
2021-02-18 |
Days after vaccination: |
24 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-19 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
- / 1 |
UN / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Cardiopulmonary failure, Condition aggravated, Dementia Alzheimer's type, Pulmonary oedema, Vital functions abnormal SMQs:, Cardiac failure (narrow), Dementia (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Respiratory failure (broad), Noninfectious myocarditis/pericarditis (broad) Life Threatening? No Birth Defect? No Died? Yes
Date died: 2021-02-18
Days after onset: 0 Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Clonazepam 3 times a day, Plavix 75mg, Depakote 500mg, Dofaxil 10mg, Ferrous Sulftate, Folic Acid, Isosorbide 30mg, Losartan 50mg, Namenda 10mg, Olanzapine 5mg at night and 2.5mg in the morning, Zoloft 50mg, Simvastatin 20mg, Trazodone 50mg Current Illness: Pulmonary edema Preexisting Conditions: Hypertensive, Alzheimer''s, cardiovascular conditions (pacemaker) Allergies: Not reported Diagnostic Lab Data: Not reported CDC Split Type: PR-61-21 Write-up: He was sent to the hospital two weeks earlier for Pulmonary Edema, he was discharged and sent to hospice. When the caregiver takes her rounds, she finds the resident without vital signs, prior to that he had not manifested any symptoms. Certification of cardio-respiratory failure secondary to Alzheimer''s disease |
|
VAERS ID: |
1124526 (history) |
Form: |
Version 2.0 |
Age: |
64.0 |
Sex: |
Female |
Location: |
Oklahoma |
Vaccinated: |
2021-02-08 |
Onset: |
2021-02-10 |
Days after vaccination: |
2 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-22 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
015M20A / 1 |
AR / SYR |
Administered by: Unknown Purchased by: ? Symptoms: Cognitive disorder, Condition aggravated, Dementia Alzheimer's type SMQs:, Dementia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad) Life Threatening? No Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? Yes ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Memantine HCL (Namenda)10mg, 2x daily Losartan Potassium. 25mg Calcium Citrate +D3 (Citracal +D3) B12 1000mcg D3 4000iu Turmeric Curcumin, 1.5g, 2x daily I Omega 3 Acid Ethyl Esters 3 gr daily Atorvastatin 10mg Donepezil HCL , 10 mg(Are Current Illness: Likely Early onset Alzheimer?s Preexisting Conditions: Allergies: None known Diagnostic Lab Data: None CDC Split Type: Write-up: Vaccine recipient had sudden and very significant cognitive decline upon waking approximately 1.5 days after receiving vaccine. |
|
VAERS ID: |
1136716 (history) |
Form: |
Version 2.0 |
Age: |
95.0 |
Sex: |
Female |
Location: |
Puerto Rico |
Vaccinated: |
2021-02-12 |
Onset: |
2021-03-03 |
Days after vaccination: |
19 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-26 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
032H20A / 2 |
UN / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Condition aggravated, Death, Dementia Alzheimer's type, Diabetes mellitus, Ulcer SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Dementia (narrow), Gastrointestinal ulceration (narrow), Immune-mediated/autoimmune disorders (broad) Life Threatening? No Birth Defect? No Died? Yes
Date died: 2021-03-03
Days after onset: 0 Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Percoset, Preprotein, Insuline Humulin N Current Illness: Non reported Preexisting Conditions: Ongoing pain / patient received hospice services Hypertension, Diabetes, Diabetic neuropathy, Arthritis, Alzheimer''s Allergies: Non reported Diagnostic Lab Data: None reported CDC Split Type: PR-78-21 Write-up: The patient referred that has no symptoms. POC was with her, until she died. She died of Alzheimer''s, diabetes and a sacral ulcer that she brought when she was admitted. |
|
VAERS ID: |
1142999 (history) |
Form: |
Version 2.0 |
Age: |
73.0 |
Sex: |
Female |
Location: |
Puerto Rico |
Vaccinated: |
2021-02-24 |
Onset: |
2021-03-05 |
Days after vaccination: |
9 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-29 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
010A21A / 2 |
UN / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Dementia Alzheimer's type, Intracranial aneurysm, Mydriasis, Unresponsive to stimuli SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad) Life Threatening? No Birth Defect? No Died? Yes
Date died: 2021-03-05
Days after onset: 0 Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Glipizide, Atorvastatin , Lisinopril 2.5 mg, Donepezil 10 mg, Levetiracetan 500 mg Current Illness: None reported Preexisting Conditions: End-stage Alzheimer''s, Brain Aneurysm, Anemia, Cholesterol, Bedridden, Diabetes Allergies: None reported Diagnostic Lab Data: None reported CDC Split Type: PR-82-21 Write-up: Patient have generalized weakness for the last few months, she stop chewing. On 3/4/2021 he stopped reacting to stimuli and had dilated pupils. Certified Alzheimer''s deseases, cerebral aneurysm. |
|
VAERS ID: |
1143040 (history) |
Form: |
Version 2.0 |
Age: |
84.0 |
Sex: |
Female |
Location: |
Puerto Rico |
Vaccinated: |
2021-01-25 |
Onset: |
2021-02-03 |
Days after vaccination: |
9 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-29 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
030L20A / 1 |
UN / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Cardio-respiratory arrest, Dementia Alzheimer's type, Gastrooesophageal reflux disease, Gastrostomy, Hypotension, Mobility decreased, Urinary retention, Weight decreased SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific dysfunction (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (broad), Noninfectious myocarditis/pericarditis (broad) Life Threatening? No Birth Defect? No Died? Yes
Date died: 2021-02-03
Days after onset: 0 Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Temazepam 15 mg, Lisinopril 10 mg, Aspirina 81 mg, Folic acid 1 mg, Atorvastatin 10 mg, Current Illness: None reported Preexisting Conditions: Kidney failure, end-stage Alzheimer''s, bedridden, chronic anemia and vascular problems Allergies: None reported Diagnostic Lab Data: None reported CDC Split Type: PR-84-21 Write-up: During the last month she was losing weight, reflux due to having PEG, low blood pressure, lack of tension. They notified relatives and hospice, she lost mobility, stopped urinating. Respiratory cardiac arrest and end-stage Alzheimer''s certified |
|
VAERS ID: |
1149917 (history) |
Form: |
Version 2.0 |
Age: |
42.0 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: |
2021-03-16 |
Onset: |
2021-03-17 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-03-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EN6207 / 1 |
LA / - |
Administered by: Public Purchased by: ? Symptoms: Abnormal behaviour, Confusional state, Dementia Alzheimer's type, Disorientation, Dysarthria, Malaise, Mobility decreased SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad) Life Threatening? No Birth Defect? No Died? No Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None Allergies: Diagnostic Lab Data: CDC Split Type: USPFIZER INC2021298353 Write-up: Equatable to the description of Alzheimer''s or dementia patients; disorientation; confusion; Knowing your doing something wrong and unable to correct it; Motor skills slowed; Fuzzy tongue; generally out of sorts feeling; This is a spontaneous report from a contactable consumer (patient). This consumer reported that a 42-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6207) at the age of 42-years, via an unspecified route of administration in left arm at 12:15 AM on 16Mar2021 at single dose for COVID-19 immunisation, in Public Health Clinic. Medical history was reported as none. No other vaccine in four weeks. No COVID-19 prior vaccination. No known allergies. Concomitant medications were not reported. At 08:30 AM on 17Feb2021, the patient had periods of disorientation, confusion. Equatable to the description of Alzheimer''s or dementia patients. Knowing you doing something wrong and unable to correct it. Motor skills slowed. Fuzzy tongue, and generally out of sorts feeling. Punctuated by periods of lucidity. No treatment received. Outcome of the events was recovering. No Covid-19 tested post vaccination. |
|
VAERS ID: |
1187030 (history) |
Form: |
Version 2.0 |
Age: |
90.0 |
Sex: |
Male |
Location: |
Utah |
Vaccinated: |
2021-02-26 |
Onset: |
2021-02-27 |
Days after vaccination: |
1 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA |
0302L20A / 2 |
RA / SYR |
Administered by: Unknown Purchased by: ? Symptoms: Aphasia, Asthenia, Blood test, Cognitive disorder, Condition aggravated, Dementia Alzheimer's type, Gait inability, Mobility decreased, Pyrexia, Urinary incontinence, Urine analysis SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad) Life Threatening? No Birth Defect? No Died? No Permanent Disability? Yes Recovered? No Office Visit? Yes ER Visit? No ER or Doctor Visit? Yes Hospitalized? No Previous Vaccinations: Other Medications: Losartan Propranolol ER Amlodipine Besylate Donepezil HCL Memantine Metformin Myrbetriq Rosuvastatin Acetaminophen/COD Ipratropium Bromide Triamcinolone Ace. Diclofenac Sodium Turmeric Curcumin Chelated Magnesium Probiotic F Current Illness: Alzheimer?s Preexisting Conditions: Arthritis, back and knee pain Allergies: Sulfa Diagnostic Lab Data: Blood and urine test inconclusive. Records at: Clinic CDC Split Type: Write-up: Urinary incontinence, weakness, loss of speech, loss of mobility (couldn''t walk), fever for almost 12 hours. Still has loss of cognitive function from before the second shot almost 2 months after. Alzheimer''s worsened. Needs more help around the house. |
|
VAERS ID: |
1206219 (history) |
Form: |
Version 2.0 |
Age: |
79.0 |
Sex: |
Male |
Location: |
New Mexico |
Vaccinated: |
2021-03-04 |
Onset: |
2021-03-06 |
Days after vaccination: |
2 |
Submitted: |
0000-00-00 |
Entered: |
2021-04-13 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN |
CDBHS5884 / UNK |
AR / IM |
Administered by: Other Purchased by: ? Symptoms: Condition aggravated, Dementia Alzheimer's type, Scan brain SMQs:, Dementia (narrow) Life Threatening? No Birth Defect? No Died? Yes
Date died: 2021-03-10
Days after onset: 4 Permanent Disability? No Recovered? No Office Visit? No ER Visit? No ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Unknown Current Illness: Dementia/alzheimers Preexisting Conditions: Low blood pressure Allergies: None Diagnostic Lab Data: Unknown CDC Split Type: Write-up: Patient was at this hospital for brain scans to determine why a sudden exacerbation of Alzheimer''s symptoms were occurring. |
|