Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 1 of 6 PagelD #: 1281
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 1 of 6 PageID #: 1281
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`INTERVENORS’ EXHIBIT 4
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`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 2 of 6 PagelD #: 1282
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 2 of 6 PageID #: 1282
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`The Vaccine Adverse Event Reporting System (VAERS) Results
`Data current as of 02/17/2023
`Results
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`DatasetDocumentation Other Data AccessHalpforResultsPrintingTips Help with Exports gern)
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`More Options [Top]Notes Citation Query Criteria
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`> VAERS dala In CDCWONDER are updated every Friday. Hence, results for the same query can change from week toweek.
`» These results are for 7,304 total events.
`>When grouped by VAERS ID, results initially don'tshowEvents Reported, Percent, or totals. Use Quick orMoreOptions to restore Sens:if you wish.
`» Click on a VAERS ID to see a report containing detailed information for the event.
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`Some measures are hidden, use Quick or More Options above to restore them.
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`‘VAERS
`a a
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`Adverse Event Description 94
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`99009095-
`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 25S5AM on
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`BONS D952 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
`0910363-
`Patient had mild hypotension, decreased oral intake, somnolence starting 3 days after vaccination and death 5 days after administration. He did have advanced dementia
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`and was hospice eligible based on history of aspiration pneumonia.
`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
`O913733-1
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`acknowledge this and I wanted to be sure a| report was made.
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`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.
`0914671-1|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.
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`Due to proximity of vaccination we felt we should report the death, even thoughit is not believed to be related.
`6915: 1|Patient died within 12 hours of receiving the vaccine.
`After vaccination, patient tested positive for COVID-19. Patient was very ill and hadnnumerous chronic health issues prior to vaccination. Facility had 3 number of patients
`6917117-1|who had already tested positive for COVID-19. Vaccination continued in an effort to prevent this patient fram contracting the virus or to mitigate his risk. This was
`unsuccessful and patient died.
`At the time of vaccination, there was an outbreak of residents who had already tested positive for COVID 19 at the nursing home where patient was a resident. About a
`week later, patient tested positive for COVID 19. She had a numberof chronic, underlying health conditions. The vaccine did not have enough time to prevent COVID 19.
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`There is no evidence thatthe vaccination caused patient's death. Tt simply |didn’t have time to saveher life.
`Prior to theadministration of the COVID19 vaccine, the nursing home had an outbreak of COVID-19, Patientwas vaccinated and about a weektater she tested. positive for
`17793-1
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`go1ies
`COVID-19. She had unéerlyingthyroid and diabetes disease. She died asa result of COVID-19 and her underlying health conditions and not as a result of the vaccine.
` Residents was found unresponsive.|Pronounced deceased at 6:02pm
`0918065- A
`0918487- 1
`Two days post vaccinepatient went into cardiac|arrest andpassed away.
`0915518-1|syncopal episode- arrested - CPR- death
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`9919537-1 Resident exhibited no adverse events during 30 minute monitoring following vaccine administration,Resident found without pulse at 1900.
`0920326-1 Redness and warmth with edema to right side of neck and under chin. Resident was on Hospice services and expired on 1.1.21
`12/30/2020 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
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`Hospice services and not have resident provided with IVF or fvAntibiotics
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`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 3 of 6 PagelD #: 1283
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 3 of 6 PageID #: 1283
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`0920815-1|Found deceased in her home, unknown cause, 6 days after vaccine.
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`0921547-1|DEATH ON 1/4/2021, RESIDENT RECIEVED VACCINE ON 1/2/20
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`Resident had body aches, a low 02 sat and had chils 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
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`Fever, RespDepression & COVID positive REMDESIVIR (EVA) 200 mg x1 then 100 mg daily
`Patient was vaccnated Dec 30, 2020. Prime dose of Modema vaccine. Observed for full 15 minutes post-injection. No complaints when asked during observation. Released.
`Subsequently, vaccine clinic staff leamed 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
`9923993-1 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.
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`0924126-1|resident expired 1/1/2021
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`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 gurgiing noises and tongue hanging out of mouth. This primary caregiver observed resident at baseline and ambulating after dinner at approximately, 1800
`less than an hourprior to incident. This PCG called 911 for EMS and gave report of inddent. Resident was taken to Medical Center Emergency Department. At ER, CT scan
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`and X-ray was performed. Per report from ER RN, CT scan and x-ray revealed an intracranial aneurysm andfluid 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 thefirst dose of COVID-19 vaccine
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`on 1/2/21. Primary caregiver received a call from Castle RN at 0700, resident expired at 0615.
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`0921572-1 a displaced hip fracture. On 1/2/21 during the NOC shift his 02 sat dropped again. He later went unresponsive and passed away.
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`0925264-1|PT was found deceased in his home on 1/5/2021
`not feeling well 01/06/2021 and passed away that day. 0526600-1
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`Patient did not report any signs or symptoms of adverse reaction to vaccine. Patient suffered from several comorbidities (diabetes and renalinsuffidency), Patient reported
`comorbidities. He died suddenly approximately 0430,it is unlikely it was related to receiving the vaccine. 0926797-1
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` No adverse effects noted after vaccination. Patient with cardiac history was found unresponsive at 16:45 on 1/6/21. Abnormal breathing pattems, eyes partially closed
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`928513-1|Resident passed away in her sleep
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`0928933-1 Patient had been diagnosed with COVID-19 on Dec. 11th, 2020. Symptoms were thought to have started on 12/5/2020. Received Moderna vaccine on 12/23. Unexpected
`—--—|death on 1/8/2021. Resuscitation attempts unsuccessful
`0929764-1
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`The patient was found deceased at home about 24 hours after immunization. Date of Death:: 12/29/2020; estimated time of death 6:00pm
`9929997-1 1/5/2021 am, he was noted to be very lethargic an could only mumble, could not swallow. No localizing neurotogic findings. He was too lethargic to get up in chair.
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`Patient received vaccine on 1/4/2021. He was in Hospice for CHF and renalfailure, but was able to get up in his wheelchair and eat and take medications and talk. On
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`0924186-1|Resident expired 1/3/21
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`0924664-1
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`had a vaccination on 12/31/2020 late morning passed away early moming 01/01/2020. This is a 93 yearold with significant heart issues. EF of 20% among other
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`0927260-1|SPO2 was 41%, pulseless with no cardiac sounds upon auscultation. CPR and pulse was regained and patient was breathing. Patient sent to Hospital ER were she remained
`in an unstable condition had multiple cardiac arrest and severe bradycardia and in the end the hospital was unable to bring her back.
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`0930154-1|Notified today that he passed away. No other details known at this time.
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`0930487-1|Medical docter state patient has a acute cardiac attack
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`wsuoezes
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`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 4 of 6 PagelD #: 1284
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 4 of 6 PageID #: 1284
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`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.
`@933578-1|Pronounced dead 1/9/2021 at 12:42. Received first dose of vaccine 1/8/2021
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`0933346-1
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`0934050-1
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`"4-2-2021 10:30 PM Complained Right arm/back hurt - took Tyleno! 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."
`Staff reported that patient was found Friday moming (Jan 8) sitting at a table with his head tilted forward and unresponsive to verbal or physical stimull. 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 unknownif this fall contributed to patient's death. An autopsy has
`been requested.
`The resident resides in an independent fiving facility/apartment. The reporter at the center was informed by his daughter he was notfeeling well on 1/1/2021 (specific
`0934263-1|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.
`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 moming and pronounced dead at 1336 on January 9, 2021
`|935292-1|Patient was reported to be deceased at home by law enforcement on 1/7/21
`as:
`0935350-1|Patient was found unresponsive at home with SpO2 20% 1/2/2021
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`Patient received the ist dose of Modema and was found deceased in her home the next day.
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`§934539-1
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`0936043-1|RESIDENT 1ST DOSE OF MODERNA VACCINE ADMINISTERED ON 01/04/2021 AT 8:30PM, RESIDENT FOUND UNRESPONSIVE ON 01/05/2021.
`0936805-
`Patient received the vaccine on 12/22/20 without complication.It was reported today that the patient was found unresponsive and subsequently expired at home on
`0936805-1 1/11/21,
`0937127-
`The facility had positive cases of COVID when we were able to begin vaccinating residents. Within about a week of vaccination, patient was tested positive for COVID. He
`99371271 was 91 years old and his immune system did not have the time to allow the vaccine to begin working before exposure. His age was a major contributing factor to his death.
`The facility had positive cases for COVID 19 when the vaccine was received and administered to patient. With her advanced age and chronic conditions, she did not have
`0937152-1
`time to build immunity between the time of vaccination and her testing positive,
`The facility had a number of positive COVID 19 cases prior to patients vaccination. Due to her advanced age, chronic condition, and exposure, patient did not have the
`time to build immunity after exposure before becoming positive.
` 9937434-t|
`1937434-1|Pt expired due to possible cardiac arrest. Unsure if this was vaccine related.
`0937569-1|patient reported expired 1/7/2021
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`0937186-1
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`"This is being reported becauseof the incident occurring 2 days after the Moderna Covid-19 vaccination. It was reported that the patient expired on 1/9/21, 2 days after
`0937818-1|receiving the Moderna vaccine. Upon screening of patient prior to administration on 1/7/21, the patient completed paperwork answering NO to the following “Do you
`currently have any active infections or acute respiratory illness or fever."™
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`8939050-1
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`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.
`"Patient received vaccine on 1/8/2021. On 1/9/2021 1 checked on patient via phone for symptoms or problems and he reported none but mild soreness atinjection site. On
`1|1/10/2021 family friend called me to tell me that patient had expired at about 8:00 pm. Patient reportedly complained of “pain™ unspecific and collapsed at home. Hospital
`reportedly told family that it appeared to be a “heart attack™."
`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.
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`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 5 of 6 PagelD #: 1285
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 5 of 6 PageID #: 1285
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`Pt collapsed at home approx 5:30 pm and died
`No adverse reactions observed after administration of medication. Patient starting complaining of shortness of breath around 0500 thefollowing moming. SPO2 checked in
`the 80s. Patient expired 01/09/2021;
`0944641-1|Patient died on 1/21-2021
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`0944732-1|Resident found unresponsive and without pulse at 05:45am.
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`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 moming shower she had a bowel movement, went imp and was non-responsive. The patient passed away at 7:45 am.
`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.
`Resident began having fever on 1/11/21 @0600. VS= T-102 B/P- 100/57 P- 112 RR- 24 02 Sat 92% on RA. MD called. Rapid COVID Test was negative. CBC,CMP, U/A were
`ordered as well as CXR. Resident's condition deciined. At 3:00pm resident started having respiratory distress and hypoxia 02 Sat 89%. Supplemental 02/mask @ SLPM. Neb
`TX, EKG, and Rocephin 1 GM ordered. Condition worsened. Resident sent to nearest ER for evaluation. Later in the evening the staff AT Medical Center called to inform staff
`that resident had expired @ 2230 as a result of Respiratory Failure and Sepsis.
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`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."
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`51 year old M with h/o 02 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 180Chours 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.
`0947129-1|Resident received Moderna vaccine on 12/23/2020 around 5 pm. At approximately 3:35 am on 12/25/2020, resident had a CVA and died on 1/1/2021 at 3:00 am.
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`Accelerated deciine in condition with decreased input, decreased responsiveness, somnolence, and death
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`Patient had no immediate effects from the vaccine, but died approximately 8 hours after receiving first dose of vaccine.
`|99478911|Resident experienced an overall deciine in condition on 1/8/21 and continued to decfine until he passed away on 1/13/21.
`0948164-1|Abdominal pain, Headaches, chest pain, loss of appetite, confusion, etevated liver enzymes 1/8- 1/15/21
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`0948181-1|Death Chest pain; irreg heart rhythm; evening of vaccine; death on toilet on 1/13/21
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`0949428-1|We got a call from a home health nurse Brandu Talamo, stating that the patient passed away.
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`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
`0949474-2|dead at 2:18pm.
`Around 00:50am on 01/15/21, C.N.A. reported thatthe resident locked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced
`0949523-1
`resident dead at 1:01 am.
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`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 dependentin 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 forfirst 72 hours after vaccination) with BP 64/52 but otherwise asymptomatic. Subsequent BP improved. On 1/4/2021 at 4:45
`0949630-1|am, pt found with respiratory rate of 30 with otherwise normalvital signs. Tachypnea persisted, so she received Equid 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 dear 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.
`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.
`0950057-
`2500571 She began seizing without warning which was complicated by cardiac arrest of uncertain etiology
`"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.
`0950073-1|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
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`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 6 of 6 PageID #: 1286
`Case 1:22-cv-00252-MSG Document 60-6 Filed 03/02/23 Page 6 of 6 PagelD #: 1286
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`""Modema COVID-19 Vaccine EUA™ It has been reported to me that pt. had gone into hospital for a heart catheterization on 1/12/2021. It was found during this procedure
`that pt. had suffered a MI. She was release to home the following day and passed awayat herresidence on 1/15/2021."
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`0950979-1|Headache after dose was given at 10:00 a.m Died at after 7:30 pm the same night the dose was given.
`"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 deciine 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, fabs, 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 ofinjectable 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 beganutilizing
`0951518-1|wheelchair most of time following thatfall. No significant injuries noted in documentation of thefalls. 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 medicationsin his food/fluid (with wife's blessing)
`and when he detected this he would occasionaily refuse to eat. Patient previously on DOAC. After pharmacy review in 12/2020 it was recommended to discontinue this as
`no clearindication 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 EXGs 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:°
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`day, the patient was discovered to also have a rash throughout his body, but it is unknown whenthis rash started.
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`09
`51688-1|Resident expired 1/17/21
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`0952713-1|Weakness, Low 02, death. Positive for COVID on 1/12/21, dies on 1/16/21
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`Resident was seen by MD on 1/11/2021 due to increasing in edema and shortness of breath. Lasix 40 mq STAT given. New orders to get a STAT CBC, CMP, and BNP.
`09:
`52881-1|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 thetoilet on 1/15/2021 in the moming where he subsequently passed away.
`Patient presented to our Emergency Department via EMSin full code status; asystole. Patient expired. Per nursing, husband stated patient awoke this AM and reported
`0953129-
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`0953129-1 pain tn back between shoulders andin bilateral shoulders. Patient then went unresponsive and husband called EMS.
`0953348-1 Patient wasliving in a nursing home with positive cases when administered. His age and chronic condition was such that he did not have time after the vaccination to avoid
`——-|exposure or develop immunity.
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`G954780-1
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`0953858-1|patient started to deciine 1/10/2021, patient seen at facility by medical professional - patient deceased 1/13/2021
`On 1/13/2021, resident had sudden emesis. Immediately following emesis he was noted without a pulse and pronounced deceased. No acute symptoms noted prior to this
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`episode. Resident does havea significant cardiac history.
`resident had a pressure ulcer to RT hip, was getting treatment on. Was scheduled to have wound debrided and wound vac applied on 1-19-2021. Appetite was poor, not
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`—_—|wanting to get out of bed, and decine in alertness. Passed away on 1-16-2021
`|0955959-4|Patient died 1 week after vaccination. According to family was having very rapid decine in status in recent weeks and they did not think related to vacdnation.
`0956811-1 Resident was noted unresponsive, no respiration, no blood pressure, no pulse, code blue called according to facility protocol, residentis full code, CPR started, 911 called,
`=~|arrived and took over from staff. Resident was pronounced dead at 1:16pm 1/18/21
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`0956903-1|mi Narrative: patient with asymptomatic covid 19, covid positive 12/10/2020.
`0956966-1
`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 dogged feeding tube.
`0956994-1 The patient had severe shortness of breath resulting in cardiac arrest on the Sth day after the vaccine. Shortness of breath started 12 hours afterinjection. On the Sth
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