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This is VAERS ID 1046845

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1046845
VAERS Form:2
Age:84.0
Sex:Female
Location:Virginia
Vaccinated:2021-02-17
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Deceased 02/18/2021 with an unknown cause of death


Changed on 5/7/2021

VAERS ID: 1046845 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Virginia
Vaccinated:2021-02-17
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Deceased 02/18/2021 with an unknown cause of death


Changed on 5/14/2021

VAERS ID: 1046845 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Virginia
Vaccinated:2021-02-17
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Deceased 02/18/2021 with an unknown cause of death

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1046845&WAYBACKHISTORY=ON

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