Autopsy findings of post-COVID-19 vaccination deaths in Tokyo Metropolis, Japan, 2021. (November 2022)

• Record Type: Journal Article
• Authors: Suzuki, Hideto; Ro, Ayako; Takada, Aya; Saito, Kazuyuki; Hayashi, Kino
• Is Part Of: Legal medicine. Volume 59(2022)
• Publication Date: 2022-11
• Subjects: COVID-19 vaccines -- Death -- Forensic autopsy; Medical jurisprudence -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Medical jurisprudence; Periodicals; 614.1
• DOI: 10.1016/j.legalmed.2022.102134
• Languages: English
• ISSNs: 1344-6223

Abstract

Highlights: Autopsy findings of post COVID-19 vaccine death were investigated. Causal relationships between cause of death and vaccine were also investigated. Many cases showed no definite causal relationship between vaccination and death. There were a few cases showing possible adverse events, such as myocarditis. Performing autopsy is necessary for detecting vaccine related death. Abstract: Background: COVID-19 vaccines have been used across Japan since 17 February 2021, and as of 17 April 2022, 1690 deaths potentially caused by vaccine-related adverse effects have been reported to the Ministry of Health, Labour and Welfare. However, the causal relationship between vaccination and death could not be fully evaluated because of a lack of sufficient information. Methods: Autopsy cases in which deaths occurred within seven days after COVID-19 vaccination in Tokyo Metropolis and were handled by medical examiners were selected (n = 54). Age, sex, vaccine-related information, cause of death, and possible causal relationship between vaccination and death were examined. Results: The mean age of the deceased individuals was 68.1 years, and the study sample consisted of 34 males (63.9%) and 20 females (37.0%). Thirty-seven and six individuals received Comirnaty and Spikevax, respectively (68.5% and 11.1% respectively). The manner of death included natural (n = 43), non-natural (n = 8), and undetermined (n = 3). The most frequent cause of death was ischemic heart disease (n = 16). Regarding causal relationships, 46 cases (85.2%) did not show a causal relationship to vaccination, except for myocarditis (n = 3), thrombosis-related death (n = 4), and others (n = 1). Conclusion: Although many cases of deaths after COVID-19 vaccination in this study showed no definite causal relationship between the vaccination and deaths, some cases showed possible adverse events such as myocarditis. Autopsies are essential for detecting vaccine-related deaths, and the Japanese death investigation system needs to be reinforced from this viewpoint.