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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1026379



Case Details

VAERS ID: 1026379 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-09
Onset:2021-02-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OXYMETAZOLINE HCL 0.05% NASAL SPRAY DISCONTINUED 30 02/09/2021 02/09/2021 02/09/2021 1 USE 1 SPRAY NASAL TWICE A DAY MAX OF 3 DAYS OF USE** DOCUSATE NA 50MG/SENNOSIDES 8.6MG TAB DISCONTINUED 60 02/09/2021 01/20/2021 01/21/2021
Current Illness: HTN-Iron def-h/o PE-chronic renal failure
Preexisting Conditions: HTN-Iron def-h/o PE-chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient 6 hours post vaccination


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