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A 43-year-old woman died four days after taking a Covid-19 vaccine booster in Singapore on Dec. 13, 2021.

An Apr. 14, 2023 coroner inquiry found that her death, which was caused by myocarditis, was likely linked to the booster.

Family received S$225,000

In an Apr. 16 press release, the Ministry of Health (MOH) stated that the family of Philippines national Ontal Charlene Vargas' had applied to its Vaccine Injury Financial Assistance Programme (VIFAP) in January 2023.

VIFAP provides one-time financial assistance to those who have been assessed to have experienced serious side effects related to Covid-19 vaccines administered in Singapore; Vargas had been working here as a foreign domestic worker at the time of her death.

Vargas family's application was reviewed by the independent clinical panel, which assessed that her demise was probably related to the Covid-19 vaccination.

They approved the application and the family received a one-time financial assistance payout of S$225,000, MOH stated.

Had difficulty the day after booster

According to court documents, Vargas received her Pfizer-BioNTech's Comirnaty booster shot — her third dose — on Dec 9, 2021.

She did not exhibit any adverse effects during her 42-minute observation at the clinic; afterwards, she went home and rested in her room.

The next morning, Vargas felt tired and breathless and told her husband over the phone that she had difficulty breathing.

She went to a clinic complaining of mild chest discomfort; Vargas remained at the GP for medical checks and observations. She was later discharged in the afternoon when she reported no further chest discomfort but was advised to visit the hospital or call an ambulance should the chest discomfort return.

She felt unwell again at around 5:30pm, told her employer she needed to go to the hospital, and took a taxi to Singapore General Hospital.

Passed away four days later

Vargas was warded for shortness of breath and chest tightness.

On Dec. 12, she said her symptoms of breathlessness and chest pain were improving in the morning, but she was later found unresponsive at 2:50pm and without a pulse at 2:54pm.

She was transferred to the Medical Intensive Care Unit, where she received a "dire prognosis".

This was communicated to her family in the Philippines, who decided on terminal extubation and Vargas passed on Dec. 13, 2021.

Cause of death: Myocarditis

When she was at the hospital, Vargas said her family did have a history of heart disease or congenital heart problems and she did not have a reaction to the first and second doses of the Pfizer-BioNTech vaccine.

Vargas was also relatively healthy and had no chronic illnesses, State Coroner Adam Nakhoda stated.

The autopsy found a benign tumour, which did not cause Vargas' death, and inflammation of the heart muscle, which was consistent with myocarditis.

Myocarditis an extremely rare adverse effect of an mRNA vaccine

Common causes for myocarditis include bacterial, viral or fungal infection, an autoimmune disease, consumption of drugs, and receiving the Covid-19 vaccine.

However, there was no evidence that Vargas had a bacterial, viral or fungal infection or autoimmune disease, or that she had consumed drugs and medication that led to myocarditis.

As Vargas developed myocarditis soon after receiving her booster, her symptoms were deemed to likely be related to the vaccine.

Myocarditis, while extremely rare, is a known adverse effect following an mRNA vaccine.

According to the latest vaccine safety update by the Health Sciences Authority (HSA), the incidence of myocarditis remains rare with reporting rates of 0.1 per 100,000 doses for the bivalent vaccines and 1.1 per 100,000 doses for the primary vaccination series of the monovalent vaccines.

Nakhoda accepted evidence from two doctors who said there was no definitive link between myocarditis and the vaccine, but found that on a balance of probabilities, it was likely that the two were related in Vargas' case.

He ruled her death as a medical misadventure.

Second coroner case of a Covid-19 vaccine-related death

This is the second time that a coroner has found a person's death to be linked to the Covid-19 vaccine; over 17 million doses of the vaccine have been administered in Singapore.

The first fatality was a 28-year-old Bangladesh national, Rajib, who died on Jul. 9, 2021.

"MOH, the Expert Committee on Covid-19 Vaccination, and HSA will continue to monitor vaccine-related serious adverse events closely," said the ministry.

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Top image by Mika Baumeister from Unsplash