From the 6/11/2021 release of VAERS data:
This is VAERS ID 1032303
| Days after vaccination:||25
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA
||025J20-2A / 1
||LA / IM
Administered by: Senior Living Purchased by: ?
General physical health deterioration,
SARS-CoV-2 test negative
SMQs:, Guillain-Barre syndrome (broad), COVID-19 (broad)
Life Threatening? No
Birth Defect? No
Date died: 2021-02-05
Days after onset: 4
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Other Medications: PUREED diet, Pureed texture DIET: DOUBLE PORTION @ ALL MEALS DIET: EXTRA PROTEIN ENTREE three times a day @ BREAKFAST, LUNCH AND DINNER NX: GLUCERNA 1.5 120CC three times a day for (SUPPLEMENT) WITH MEDPASS Zinc Sulfate Tablet 220 (50 Zn)
Current Illness: On monitoring for declining in condition, loss of appetite and generalized body weakness on2/1/2021
Preexisting Conditions: Hemiplegia & Hemiparesis on left non-dominant side Atherosclerotic heart Dse. Type 2 Diabetes Mellitus Cerebral Infarction PAF Thyroid Disorder Hypertension Cerebral edema GERD Occipital Neuralgia
Diagnostic Lab Data: labs were ordered prior rto admitting to Hospice Care. NEGATIVE for COVID-19 on 2/1/2021.
CDC Split Type:
Write-up: On monitoring for declining in condition, loss of appetite and generalized body weakness on2/1/2021. Was confirmed COVID-19 positive 4/23/2020.
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