How do VAERS and V-safe differ in reporting vaccine-related deaths and adverse events?

1. What each system is and who reports

VAERS (Vaccine Adverse Event Reporting System) is a national passive surveillance system co‑managed by CDC and FDA that accepts reports from healthcare providers, vaccine manufacturers, and the public to monitor adverse events that occur after vaccination ^{[1] [3]}. V‑safe is described in the supplied material as an active smartphone‑based monitoring protocol established for COVID‑19 vaccines that enrolls vaccine recipients for scheduled check‑ins; researchers have used V‑safe outputs as a data source when estimating reporting gaps in VAERS ^{[4] [5]}. The key operational distinction in the sources: anyone can submit to VAERS at any time (passive), while V‑safe proactively contacts enrolled individuals (active follow‑up) ^{[3] [4]}.

2. How deaths and adverse events get into each database

VAERS collects “unverified reports” of any health event after vaccination — minor or serious — and those reports can come from anyone; VAERS guidance explicitly warns the public that a report does not prove the vaccine caused the event ^{[2] [3]}. V‑safe’s protocol, as cited by independent analysts, includes active prompts and a pathway where “significant medically attended health events” reported in V‑safe can trigger outreach and referral to VAERS reporting ^[4]. In short, VAERS is a catchall for spontaneously submitted post‑vaccination events, while V‑safe is an enrollment‑based active surveillance tool that can surface events and lead to VAERS reporting ^{[4] [5]}.

3. Verification, interpretation and causation

The CDC and FDA use VAERS to detect signals but emphasize that VAERS data are raw, unverified, and require further study to determine causality; follow‑up investigations typically use other systems such as the Vaccine Safety Datalink (VSD), CISA, or FDA BEST to assess links ^{[2] [3]}. The Annenberg analysis cited in the sources argues VAERS is frequently misinterpreted and recommends clearer public framing because raw VAERS entries are not confirmed medical findings ^[7]. V‑safe’s active follow‑up can produce more structured reports (and prompts to report to VAERS), but the supplied sources do not claim V‑safe alone establishes causal links; it is primarily a nearer‑term monitoring and outreach system ^{[4] [5]}. Available sources do not mention V‑safe performing independent causality adjudication.

4. Reporting completeness and underreporting

Underreporting is a fundamental limitation of passive surveillance like VAERS; studies in the supplied items estimate VAERS sensitivity for specific adverse events (e.g., anaphylaxis, Guillain‑Barré) can be low and variable (ranges roughly 12–76% depending on event and vaccine), showing VAERS may capture only a fraction of true cases identified in active systems like VSD ^[6]. Independent analysts have used V‑safe data to estimate an “under‑reporting factor” (URF) for VAERS, with some calculations cited in the sources suggesting large multipliers (e.g., 31× to 51× in certain analyses), though those are independent estimates and not CDC determinations ^{[4] [5]}. The CDC and FDA acknowledge VAERS’ underreporting and treat VAERS as one of multiple systems in a multi‑system safety surveillance strategy ^[3].

5. How deaths specifically are treated and presented

VAERS accepts reports of deaths following vaccination but the system’s public data are unverified case reports; the CDC warns that media or websites sometimes present VAERS death reports as confirmed vaccine deaths, which the agencies say is misleading because causality requires further investigation ^[2]. VAERS policy and public resources reiterate that an event appearing in VAERS — including death — is a signal that may prompt review in VSD, CISA, or FDA BEST, not a final adjudication of cause ^{[3] [2]}. Available sources do not provide a numeric comparison of how many deaths are captured in VAERS versus V‑safe; they note instead differences in sources, completeness and the need for follow‑up ^{[2] [4]}.

6. Competing perspectives and limitations

Public health authorities (CDC/FDA) present VAERS as an early‑warning, national passive system and stress data limitations and the need for complementary active systems ^{[1] [3]}. Independent researchers and advocacy projects cited here (OpenVAERS, Jessica Rose, others) use V‑safe outputs to argue VAERS undercounts events and compute URFs, a perspective that draws scrutiny because those URF calculations are not official CDC estimates and rest on methodological assumptions ^{[4] [5] [6]}. The supplied sources make clear both approaches provide value: VAERS for wide‑net, rapid signal detection and systems like V‑safe or VSD for more complete, quantifiable follow‑up ^{[3] [6]}.

Limitations: this summary uses only the provided sources and those sources do not contain a single authoritative, side‑by‑side technical spec comparing how VAERS and V‑safe record deaths; where a claim is not present in the supplied reporting I have flagged it as “available sources do not mention” or cited the relevant document ^{[4] [2]}.