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Singapore has been using mRNA vaccines developed by Pfizer-BioNTech and Moderna as part of the nation’s COVID vaccination program since 30 December 2020. From 1 February 2021–30 June 2021, a total of 34 deaths that occurred within 72 h of the deceased receiving their COVID-19 vaccination were referred to the Forensic Medicine Division of the Health Sciences Authority of Singapore. Autopsies, histological sampling and ancillary investigations consisting of total tryptase level, Immunoglobulin E (IgE), and C-reactive Protein (CRP), were performed on 29 of these cases. Our study has shown no definite causative relationship between the mRNA vaccination and deaths of individuals who died within 72 h after receiving the vaccination, in particular with regards to anaphylactic reactions, myocarditis and pericarditis, and thrombotic complications. Further studies may consider increasing the incident time frame from 72 h to seven days post-vaccination or longer to include any potential delayed presentation of adverse effects.
•Death or collapses within 72 h post-mRNA COVID-19 vaccination were investigated.•No definite causative relationship between mRNA vaccination and deaths were found.•Further studies to consider increasing timeframe to include delayed adverse effects.