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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1088539



Case Details

VAERS ID: 1088539 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-02-11
Onset:2021-02-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Muscle rigidity, Peripheral coldness, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-24
   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: Lactulose 22.5 ml tid; omeprazole 40 mg daily; rifaximin 550 mg bid
Current Illness: end stage liver disease due to alcoholic cirrhosis with undiagnosed liver mass; chronic hepatitis C.; and hepatic encephalopathy
Preexisting Conditions: alcoholism; hepatitis c with end stage liver disease and hepatic encephalopathy, macrocytic anemia, poly-substance abuse, non-compliant with medical treatment
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: He was found unresponsive, cold and with rigor mortis present after family requested welfare check. He had not been seen for 36 hours.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1088539

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