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Review

A SYSTEMATIC REVIEW OF AUTOPSY FINDINGS IN DEATHS AFTERCOVID-19 VACCINATION

Nicolas Hulscher, BS 1*, Paul E. Alexander, PhD2, Richard Amerling, MD3,ev

Heather Gessling, MD3, Roger Hodkinson, MD3, William Makis, MD4, Harvey A.

err

Risch, MD, PhD5, Mark Trozzi, MD3, Peter A. McCullough, MD, MPH3 6

1University of Michigan School of Public Health, Ann Arbor, MI, USApe

2Former Senior Pandemic Advisor to A Secretary, Health and Human Services(HHS, Washington, DC, former Assistant Professor in evidence-based medicine
and epidemiology, former WHO-PAHO COVID consultant (evidence synthesis;otpresent, advisor to The Wellness Company USA and Canada, Boca Raton, FL

tn

3 Wellness Company, Boca Raton, FL

4Cross Cancer Institute, Alberta Health Services, 11560 University Avenue,rin

Edmonton, AB T6G 1Z2, Canada.
5Professor Emeritus, Yale University School of Public Health, New Haven, CT

ep

6Truth for Health Foundation, Tucson, AZ, ORCID ID:

0000-0002-0997-6355

Pr*Correspondence: nichulscher@gmail.com (Nicolas Hulscher)
Word Count: 2281

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Abstract

Background: The rapid development and widespread deployment of COVID-19
vaccines, combined with a high number of adverse event reports, have led toconcerns over possible mechanisms of injury including systemic lipid nanoparticle

ev(LNP) and mRNA distribution, spike protein-associated tissue damage,thrombogenicity, immune system dysfunction, and carcinogenicity. The aim of thiserrsystematic review is to investigate possible causal links between COVID-19
vaccine administration and death using autopsies and post-mortem analysis.

peMethods: We searched for all published autopsy and necropsy reports relating to
COVID-19 vaccination up until May 18th, 2023. We initially identified 678 studies

otand, after screening for our inclusion criteria, included 44 papers that contained
325 autopsy cases and one necropsy case. Three physicians independently

tnreviewed all deaths and determined whether COVID-19 vaccination was the directrincause or contributed significantly to death.

ep

Findings: The most implicated organ system in COVID-19 vaccine-associateddeath was the cardiovascular system (53%), followed by the hematological system

Pr(17%), the respiratory system (8%), and multiple organ systems (7%). Three ormore organ systems were affected in 21 cases. The mean time from vaccination toThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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death was 14.3 days. Most deaths occurred within a week from last vaccine

administration. A total of 240 deaths (73.9%) were independently adjudicated as
directly due to or significantly contributed to by COVID-19 vaccination.

ev

Interpretation: The consistency seen among cases in this review with known

COVID-19 vaccine adverse events, their mechanisms, and related excess death,errcoupled with autopsy confirmation and physician-led death adjudication, suggests
there is a high likelihood of a causal link between COVID-19 vaccines and deathin most cases. Further urgent investigation is required for the purpose of clarifyingpe

our findings.

otKeywords: Autopsy; necropsy; COVID-19; COVID-19 vaccines; mRNA; SARS-

Pr

ep

rin

tn

CoV-2 vaccination; death; excess mortality; spike protein; organ system

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Research in context
Evidence before this study

COVID-19 vaccines, with known mechanisms of injury to the human body and asubstantial number of adverse event reports, represent an exposure that weev

hypothesized to be possibly linked to death in some cases. Thus, we searched

PubMed and ScienceDirect for all published autopsy and necropsy reports relatingerr

to COVID-19 vaccination through May 18th, 2023 using keywords relating to
COVID-19 vaccines, death, autopsy, and necropsy. We found that nocomprehensive review of autopsy findings in a large series of deaths after COVID-

pe

19 vaccination that accounts for the current state of knowledge has been
conducted. The mechanisms of death from COVID-19 vaccination remain largely

ot

unexplored.

tn

Added value of this studyrin

Because the state of knowledge has advanced since the time of the original
publications, new assessments regarding COVID-19 vaccine adverse events can be

ep

made. Based on the previously published literature of COVID-19 vaccine adverse
events, their mechanisms, and related excess death, coupled with autopsyPrconfirmation and physician-led death adjudication, we found a high likelihood of acausal link between COVID-19 vaccines and death among most of the 326

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included cases. This is the first study that indicates a high probability of causality

between COVID-19 vaccine administration and death in many cases. To date, thisis the largest review of autopsy findings in deaths after COVID-19 vaccination,

syndromes.

errImplications of all the available evidenceev

helping the medical community to better understand fatal COVID-19 vaccine

Further urgent investigation is required aimed at confirming our results and further
elucidating the mechanisms underlying the described fatal outcomes with the goalpeof risk mitigation for the large numbers of individuals who have taken one or more
COVID-19 vaccines. If a large number of deaths are indeed causally linked toot

COVID-19 vaccination, the implications could be immense, including: thecomplete withdrawal of all COVID-19 vaccines from the global market,tnsuspension of all remaining COVID-19 vaccine mandates and passports, loss ofrinpublic trust in government and medical institutions, investigations and inquiries
into the censorship, silencing and persecution of doctors and scientists who raised

ep

these concerns, and compensation for those who were harmed as a result of thePradministration of COVID-19 vaccines.

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Introduction

As of May 31st, 2023, SARS-CoV-2 has infected an estimated767,364,883 people globally, resulting in 6,938,353 deaths1. As a direct responseto this worldwide catastrophe, governments adopted a coordinated approach toev

limit caseloads and mortality utilizing a combination of non-pharmaceuticalinterventions (NPIs) and novel gene-based vaccine platforms. The first doses of

errvaccine were administered less than 11 months after the identification of the
SARS-CoV-2 genetic sequence (in the United States, under the
Operation Warp Speed initiative), which represented the fastest vaccinepedevelopment in history with limited assurances of short and long-term safety2. At
the time of writing, about 69% of the world population have been inoculated withot

at least one dose of a COVID-19 vaccine1.

tn

The most frequently utilized COVID-19 vaccine platforms include

rin

inactivated virus (Sinovac – CoronaVac), protein subunit (Novavax – NVXCoV2373), viral vector (AstraZeneca – ChAdOx1 nCoV-19, Johnson & Johnson –ep

Ad26.COV2.S), and messenger RNA (Pfizer-BioNTech – BNT162b2, Moderna –mRNA-1273)3. All utilize mechanisms that can cause serious adverse events; mostPr

involve the uncontrolled synthesis of the spike glycoprotein (SP) as the basis of theimmunological response. Circulating SP is the likely deleterious mechanism

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through which COVID-19 vaccines produce adverse effects4,5,7,8,10,11. SP and/or
subunits/peptide fragments can trigger ACE2 receptor degradation andinternalization, which may also cause destabilization of the renin–angiotensin

system (RAS), resulting in possible enhanced inflammation, vasoconstriction, andev

thrombosis4. SP activates platelets, causes endothelial damage, and directly

promotes arterial and venous thrombosis5. Moreover, immune system cells thaterrhave taken up the lipid nanoparticles (LNPs) then release them back into thecirculation with elevated numbers of exosomes containing SP and microRNAs thatplay a role in inducing a signaling response in recipient cells at distant sites,pe

resulting in severe inflammatory consequences5. Further, long term cancer control
may be jeopardized in those injected with mRNA COVID-19 vaccines because ofot

IRF7 and IRF9 suppression5. There is a distinct potential of a causal link between
SARS-CoV-2 mRNA vaccination and neurodegenerative disease, myocarditis,tn

immune thrombocytopenia, Bell's palsy, liver disease, impaired adaptiverinimmunity, impaired DNA damage response and tumorigenesis5.
These findings are supported by the recent discovery that repeated COVID-19

ep

vaccination with mRNA-based vaccines causes production of abnormally highlevels of IgG4 antibodies which can lead to immune tolerance to SP, immune

Prsuppression, and promote the development of autoimmune diseases, myocarditis,and cancer growth6.

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Neurotoxic effects of SP may cause or contribute to the post-COVID

syndrome, including headache, tinnitus, autonomic dysfunction, and small fiber
neuropathy7. Specific to the administration of viral vector COVID-19 vaccines

ev(AstraZeneca; Johnson and Johnson) a new clinical syndrome called vaccine-induced immune thrombotic thrombocytopenia (VITT) was identified in 2021 anderrcharacterized by the development of thromboses at atypical body sites combinedwith severe thrombocytopenia after vaccination9. The pathogenesis of this lifethreatening side effect is currently unknown, though it has been proposed thatpe

VITT is caused by post-vaccination antibodies against platelet factor 4 (PF4)triggering extensive platelet activation9. mRNA-based vaccines rarely cause VITT,

ot

but they are associated with myocarditis, or inflammation of myocardium10. The
mechanisms for the development of myocarditis after COVID-19 vaccination aretn

not clear, but it has been hypothesized that it may be caused by molecular mimicryrin

of SP and self-antigens, immune response to mRNA, and dysregulated cytokine
expression10. In adolescents and young adults diagnosed with post-mRNA vaccine

ep

myocarditis, free SP was detected in the blood while vaccinated controls had no
circulating SP11. It has been demonstrated that SARS-CoV-2 spike mRNA vaccinePrsequences can circulate in the blood for at least 28 days after vaccination12. These

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data indicate that adverse events may occur for an unknown period after
vaccination, with SP playing an important potential etiological role.

A Freedom of Information Act (FOIA) document obtained from theevAustralian Government, titled Nonclinical Evaluation of BNT162b2 [mRNA]

COVID-19 vaccine (COMIRNATY), shows systemic distribution of the LNPs

err

containing mRNA after vaccine administration in rats, concluding that LNPs
reached their highest concentration at the injection site, followed by the liver,spleen, adrenal glands, ovaries, and bone marrow (femur) over 48 hours13. Thispebiodistribution data suggests that SP may be expressed in cells from many vitalorgan systems, raising significant concerns regarding the safety profile of COVID-

ot

19 vaccines. Given the identified vaccination syndromes and their possible
mechanisms, the frequency of adverse event reports is expected to be high,

rin

tn

especially given the vast number of vaccine doses administered globally.

Through May 5th, 2023, the Vaccine Adverse Events Reporting System

ep(VAERS) contained 1,556,050 adverse event reports associated with COVID-19
vaccines, including 35,324 deaths, 26,928 myocarditis and pericarditis, 19,546

Pr

heart attacks, and 8,701 thrombocytopenia reports14. If the alarmingly high numberof reported deaths are indeed causally linked to COVID-19 vaccination, theThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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implications could be immense, including: the complete withdrawal of all COVID19 vaccines from the global market, suspension of all remaining COVID-19

vaccine mandates and passports, loss of public trust in government and medical
institutions, investigations and inquiries into the censorship, silencing andevpersecution of doctors and scientists who raised these concerns, and compensation
for those who were harmed as a result of the administration of COVID-19

err

vaccines. Using VAERS data alone to establish a causal link between COVID-19
vaccination and death, however, is not possible due to many limitations andpeconfounding factors.

Autopsies are one of the most powerful diagnostic tools in medicine tootestablish cause of death and clarify the pathophysiology of disease15. COVID-19
vaccines, with plausible mechanisms of injury to the human body and a substantial

tnnumber of adverse event reports, represent an exposure that may be causally linked

rin

to death in some cases. The purpose of this systematic review is to investigate
possible causal links between COVID-19 vaccine administration and death using

ep

autopsies and post-mortem analysis.

Pr

Methods

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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We performed a systematic review of all published autopsy and necropsy
reports relating to COVID-19 vaccination through May 18th, 2023. All autopsy
studies that include COVID-19 vaccines as a possible cause of death were

included. All necropsy (analysis of dead tissue) studies that include COVID-19

ev

vaccines as a possible cause of organ death were included. No other restrictions
were imposed. The following databases were used: PubMed and ScienceDirect.

err

The following keywords were used: ‘COVID-19 Vaccine’, ‘SARS-CoV-2
Vaccine’, ‘COVID Vaccination’, and ‘Post-mortem’, ‘Autopsy’, or ‘Necropsy’.
All selected studies were screened for relevant literature contained in theirpereferences. Because the state of knowledge has advanced since the time of theoriginal publications, we performed a contemporary review: three physicians (RH,ot

WM, PAM) with experience in death adjudication and anatomical/clinicalpathology independently reviewed the available information of each case andtndetermined whether or not COVID-19 vaccination was the direct cause or

rin

contributed significantly to the mechanism of death described. Agreement wasreached when two or more physicians adjudicated the case concordantly. For the

ep

study by Chaves20, only cardiovascular and hematological system related cases
were adjudicated as being linked to the vaccine due to a high probability ofPr

COVID-19 vaccination contributing to death and missing individual caseinformation for the other individuals. Given the presence of some missing data, weThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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used all available information to calculate the descriptive statistics. Estimated age(exact age not given) and inferred time from last vaccine administration to death(no definitive time given) were excluded from calculations.

ev

Results

A database search yielded 678 studies that had potential to meet ourerr

inclusion criterion. 562 duplicates were screened out. Out of the remaining 116
papers, 36 met our specified inclusion criterion. Through further analysis ofreferences, we located 18 additional papers, with 8 of them meeting our inclusionpecriterion. In total, we found 44 studies that contained autopsy or necropsy reportsotof COVID-19 vaccinees (Figure 1).

Table 1 summarizes the 44 studies16-59. There were a total of 325 autopsytncases and 1 necropsy case (heart). The mean age of death was 70.4 years and there

rinwere 139 females (42.6%). Most received a Pfizer/BioNTech vaccine (41%),
followed by Sinovac (37%), AstraZeneca (13%), Moderna (7%), Johnson &ep

Johnson (1%), and Sinopharm (1%).

Pr

The cardiovascular system was most frequently implicated (53%), followed

by hematological (17%), respiratory (8%), multiple organ systems (7%),

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neurological (4%), immunological (3%), and gastrointestinal (1%). In 7% of cases,

the cause of death was either unknown, non-natural (drowning, head injury, etc.) or
infection (Figure 2). One organ system was affected in 302 cases, two in 3 cases,ev

three in 8 cases, and four or more in 13 cases (Figure 3).

The number of days from vaccination until death was 14.3 (mean), 3

err(median) irrespective of dose, 7.8 (mean), 3 (median) after one dose, 23.2 (mean),
2 (median) after two doses, and 5.7 (mean), 2 (median) after three doses. The
distribution of days from last vaccine administration to death is highly rightpeskewed, showing that most of the deaths occurred within a week from last
vaccination (Figure 4). 240 deaths (73.9%) were independently adjudicated byot

three physicians to be significantly linked to COVID-19 vaccination (Table S1).
Among adjudicators, there was complete independent agreement (all threetnphysicians) of vaccination causing or contributing to death in 203 cases (62.5%).

rin

The one necropsy case was judged to be linked to vaccination with complete

epagreement.

Discussion

Pr

We found 73.9% of deaths after COVID-19 vaccination were attributable tofatal vaccine injury syndromes. The cardiovascular system was by far the mostThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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implicated organ system in death, followed by hematological, respiratory, multiple
organ systems, neurological, immunological, and gastrointestinal (Figure 2), withthree or more organ systems affected in 21 cases (Figure 3). The majority of deaths
occurred within a week from last vaccine administration (Figure 4) and wereev

independently adjudicated by three physicians to be significantly associated withvaccination (Table S1). These results corroborate known COVID-19 vaccine-errinduced syndromes and show significant, temporal associations between COVID19 vaccination and death involving multiple organ systems, with a predominant
implication of the cardiovascular and hematological systems. Criteria of causalitypefrom an epidemiological perspective have been met including biologicalplausibility, temporal association, internal and external validity, coherence,ot

analogy, and reproducibility with each successive report of death after COVID-19

tn

vaccination.

rin

Our findings amplify concerns regarding COVID-19 vaccine adverse eventsand their mechanisms. SP’s deleterious effects5,6,7,8,10,11, especially on the heart10,11,

ep

likely explains the high proportion of cardiovascular deaths seen in our study. They
also highlight the involvement of multiple organ systems in some of the deathsPrassociated with COVID-19 vaccination. This might be attributed to theMultisystem Inflammatory Syndrome (MIS) that has been detected following

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COVID-19 vaccination in both children60 and adults61. A possible mechanism bywhich MIS occurs after vaccination could be the systemic distribution of the LNPs
containing mRNA after vaccine administration13 and the consequent systemic SP
expression and circulation resulting in system-wide inflammation. A significant

ev

proportion of cases were due to hematological system adverse events, which is not
surprising given that VITT62 and pulmonary embolism (PE)63 have been reportederrin the literature as serious adverse events following COVID-19 vaccination. Deaths
caused by adverse effects to the respiratory system were also relatively common in
our review, a finding that is in line with the possibility of developing acutepe

respiratory distress syndrome (ARDS) or drug-induced interstitial lung disease(DIILD) after COVID-19 vaccination64,65. Although uncommon among cases inotthis study, immunological66, neurological67, and gastrointestinal68 adverse events
can still occur after COVID-19 vaccination and, as with the cardiovascular system,tn

may be directly or indirectly caused by the systemic expression or circulation ofrin

SP. Given the average time (14.3 days) in which cases died after vaccination, a
temporal association between COVID-19 vaccination and death among most cases

ep

is further supported by the finding that SARS-CoV-2 spike mRNA vaccine
sequences can circulate in the blood for at least 28 days after vaccination12. Most

Prof the deployed vaccine platforms are associated with death, suggesting that theyshare a common feature that causes adverse effects, which is most likely SP.

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The large number of COVID-19 vaccine induced deaths evaluated in thisreview is consistent with multiple papers that report excess mortality after

vaccination. Pantazatos and Seligmann found that all-cause mortality increased 0-

ev

5 weeks post-injection in most age groups resulting in 146,000 to 187,000 vaccineassociated deaths in the United States between February and August of 202169.

errWith similar findings, Skidmore estimated that 278,000 people may have diedfrom the COVID-19 vaccine in the United States by December 202170. These
concerning results were further elucidated by Aarstad and Kvitastein, who foundpethat among 31 countries in Europe, a higher population COVID-19 vaccine uptake
in 2021 was positively correlated with increased all-cause mortality in the first nineotmonths of 2022 after controlling for alternative explanations71. Furthermore,
excess mortality from non-COVID-19 causes has been detected in many countriestnsince the mass vaccination programs began72,73,74,75,76,77, suggesting a common

rindeleterious exposure among populations. Pantazatos estimated that VAERS deaths
are underreported by a factor of 2069. If we apply this underreporting factor to theep

May 5th, 2023, VAERS death report count of 35,32414, the number of deaths in the
United States alone becomes 706,480. If this extrapolated number of deaths werePr

to be confirmed, the COVID-19 vaccines would represent the largest medical
failure in human history.

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In summary, we identified a large series of deaths after COVID-19

vaccination, confirmed with autopsy and necropsy, to help the medical community
better understand fatal COVID-19 vaccine syndromes. The consistency seenevamong cases in this review with known COVID-19 vaccine adverse events, theirmechanisms, and related excess death, coupled with autopsy confirmation anderrexpert physician death adjudication, suggests there is a high likelihood of a causal
link between COVID-19 vaccines and death in most cases. Even with substantial
evidence, our paper cannot definitively determine causality as our paper has all thepelimitations of systematic reviews of previously published papers including
selection bias, publication bias, and confounding variables. Further urgent

ot

investigation is required aimed at confirming our results and further elucidating themechanisms underlying the described fatal outcomes with the goal of risktnmitigation for the large numbers of individuals who have taken one or morerin

COVID-19 vaccines.
Acknowledgements

ep

None.

Conflict of Interest

Pr

Drs Alexander, Amerling, Hodkinson, Makis, McCullough, Risch, Trozzi areaffiliated with and receive salary support and or hold equity positions in The

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Wellness Company, Boca Raton, FL which had no role in funding, analysis, or
publication.

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10.3390/vaccines10101702. PMID: 36298567; PMCID: PMC9607451.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Figure Legends

Figure 1: Preferred Reporting Items for Systemic Reviews and Meta-Analyses(PRISMA) flow diagram detailing the study selection process.

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Figure 2: Proportion of Cases by Affected Organ SystemerrFigure 3: Number of Affected Organ Systems by Cases

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Figure 4: Distribution of Time from Last Vaccine Administration to Death

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Table Legends

Table 1: Characteristics of included studies on COVID-19 vaccination possibly
causing death.

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Supplemental Table 1: Detailed Case Information and Death Adjudications

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Figure 1.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Figure 2.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Figure 3.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

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Figure 4.

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

AUTHOR

YEA
R
2023

COUNTR CASE AGE
Y
S*
USA
1

SEX VACCIN DOS
E
E**
Moderna

2023

Japan

1

14

F

Pfizer

3

2023

Korea

1

19

M

Pfizer2

ESPOSITO[19]
CHAVES
[20]

2023

Italy

1

83

M

Pfizer2022

Columbia 121

84
52% Sinovac,(mean F
AZ,)
Pfizer

1-2

MORZ [21]2022Germany

1

76

M

2

ALUNNI[22]
TAKAHASHI [23]
MURATA[24]

2022

France

1

70

M

AZ

1

2022

Japan

1

‘90s’

M

Pfizer

3

2022

Japan

SATOMI[25]
SUZUKI[26]

2022

HOJBERG[16]
NUSHIDA[17]
JEON [18]

r
P
2021

p
e
Japan
Japan

n
t

ir n
4
1

54

34
M
(mean
)
61
F

ORGAN
SYSTEM
Eosinophili Immunologic
a
al
MIS
MIS
Multiplesclerosis
COVID-19

2

Moderna 2, Pfizer
Pfizer1

68.1
37% Pfizer,
1-2(mean F
Moderna

SCD, MI,PE

Neurological
MIS

d
e

PERIOD PROCEDU***
RE‘recent’ Autopsy

w
ie

v
e

r
r
e
e
p

Pfizerto

DISEASE

2 daysAutopsy

182 days

Autopsy
Autopsy

Cardiovascular,
HematologicalEncephaliti MIS
21 dayss,
myocarditis
VITT
Hematologica 25 daysl
Pericarditis Cardiovascul 14 daysar
Cytokine
Immunologic 1-10 days
Storm
al

Autopsy

Myocarditis
Various

10 days

Autopsy<7 days

Autopsy

CardiovascularVariousThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

Autopsy

Autopsy
Autopsy
Autopsy

2022

Italy

1

)
54

YOSHIMUR 2022
A [28]RONCATI
2022
[29]

Japan

1

88

Italy

3

PfizerKANG [30]

2022

Korea

1

72.3
2F
(mean
)
48
F

KAMURA
[31]

2022

Japan

1

57

M

Moderna 1

ISHIOKA[32]
GILL [33]

2022

Japan

1

67

M

Pfizer

1

2022

USA

2

Pfizer2

POMARA[34]
YEO [35]

2022

Italy

1

‘teena M
ge’
37
F

AZ

1

2022

Singapore 28

MELE [27]

AMERATU 2022
NGA [36]GUNTHER 2021
[37]
PERMEZEL 2022

r
P

p
e
New
ZealandGermany
Australia

M

J&J

F

Moderna 2

VI-ARDS
VITT

ir n

1-2

d
e

VITT

Hematologica ~21 dayslRespiratory
18 days

2

w
ie

v
e

r
r
e
e
p

AZ,
Pfizer

t
o

n
t

1

Myocarditis (required
transplant,
no death)
Thrombosis/rhabdom
yolysisExacerbati
on of UIP
Myocarditis
VITT

Pfizer,1-2
Moderna

Various

1

65.1
17.9
(mean % F)
57
F

Pfizer

1

1

54

M

AZ

1

Myocarditi
s
VITT

1

63

M

AZ

1

ADEM

Autopsy
Autopsy

Hematologica 18-122
ldays

Autopsy

Cardiovascular

15 days

Necropsy(heart)MIS

53 days

Autopsy

Respiratory

3 daysAutopsy

Cardiovascul 3-4 daysarHematologica 24 daysl
Various<3 days

Autopsy

Cardiovascular
Hematological
Neurological

3 daysAutopsy~121
days
32 days

AutopsyThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

Autopsy
Autopsy

Autopsy

[38]CHOI [39]

2021

Korea

1

22

SCHNEIDE
R [40]

2021

Germany

18

VERMA
[41]
WIEDMANN [42]

2021

USA

1

62.6
50% AZ,
1-2(mean F
Pfizer,)Moderna, J&J
42M
Moderna 2

2021

Norway4

POMARA
[43]

2021

Italy

2

ALTHAUS[44]

2021

Germany2

EDLER [45] 2021

Germany

3

HANSEN[46]

2021

Germany

BARONTI[47]

2022

ITTIWUT

r
P
2022

p
e
Italy

Thailand

41.8
(mean
)
43.5
(mean
)
36
(mean
)
‘elder
ly’

M

F

AZ

1F

AZ

t
o

1F

n
t

ir n

PfizerAZ

1

CardiovascularVariousde

5 daysw
ie

Autopsy

1-14 days Autopsyve

Myocarditis
VITT

Cardiovascul ~14 days AutopsyarHematologica 7-25 days Autopsyl

VITT

Hematologica 16-24
ldays

Autopsy1

VITT

Hematologica 16-17
ldays

Autopsy

COVID-19, Cardiovascul
MI, PEar,
Hematological, Respiratory
Renal/respi MIS
ratoryfailureMI
Cardiovascular2-12 days Autopsy

Various

r
r
e
e
p
1

1F

Pfizer

1

M

Pfizer

1

1

86

5

64
1F
Pfizer,1-2(meanModerna)
42.8
23% AZ,
1-3

13

Myocarditis
Various

Various26 days

Autopsy<1 day –21 days

Autopsy

1-7 days

AutopsyThis preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

[48]GREINACH
ER [49]MAURIELLO [50]
BJØRNSTA
D-TUVENG[51]
SCULLY[52]
CHOI [53]2021Germany

149

F

Sinopharm,
Sinovac,
Pfizer,Moderna
AZ
1

2021

Italy

1

48

F

AZ

2021

Norway

1

‘youn
g’

F

AZ

2021

U.K.

1

52

F

AZ

2021

Korea

1

38

M

J&J

SCHWAB[54]

2023

Germany

5

HIRSCHBU
HL [55]2022

Germany

29

57.6
3F
(mean
)
32-97 45%F

HOSHINO[56]
COLOMBO
[57]

2022

Japan

2023

p
e

MOSNA
[58]

(mean F
)

Italy

r
P
2022

Slovakia

ir n
1

27

5

72
2F
(mean
)
71
M

1

M

VITT

1

VITT

1

VITT

1

VITT

1

SCLS

w
ie

v
e

r
r
e
e
p

Hematologica 10 daysl
Hematologica 39 daysl
Hematologica ~10 dayslAutopsy~>10days
2 daysAutopsy<7 days

Autopsy

Autopsy
Autopsy

Pfizer,1-2
Moderna

Myocarditis

HematologicalHematologicalCardiovascular

Pfizer,
1-2
AZ,
SinovacModerna 1

COVID-19

Various~1-307days

Autopsy

CardiovascularRespiratory,MIS

36 days

Autopsy

188-298
days

Autopsy

Neurological

10 days

Autopsy

t
o

n
t

d
e

Pfizer2

Myocarditis
VariousPfizer2

GBS

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

AutopsyKAIMORI
[59]

2022

Japan

1

72

F

Pfizer

1

d
e

TMA

Hematologica 2 days
l

w
ie

v
e

*Cases = Number of deaths examined post-mortem**Dose = Cumulative number of vaccine doses received***Period = Time (in days) from most recent vaccine administration to death~ = Inferred Period (Estimated period using all available information, definitive period not given)

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p

Table 1.

t
o

n
t

r
P

p
e

ir n

This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=4496137

Autopsy