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This is VAERS ID 1098902

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1098902
VAERS Form:2
Age:59.0
Sex:Male
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-21
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: Diabetic, coronary heart disease
Preexisting Conditions: Diabetic, coronary heart disease
Allergies:
Diagnostic Lab Data: Autopsy not done due to known health conditions and no fowl play. Understood that death was likely caused by his Heath issues, but just wanted the death reported in case there are later findings about the vaccines and potential complications.
CDC 'Split Type':

Write-up: Death


Changed on 5/7/2021

VAERS ID: 1098902 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-21
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: Diabetic, coronary heart disease
Preexisting Conditions: Diabetic, coronary heart disease
Allergies:
Diagnostic Lab Data: Autopsy not done due to known health conditions and no fowl play. Understood that death was likely caused by his Heath issues, but just wanted the death reported in case there are later findings about the vaccines and potential complications.
CDC 'Split Type':

Write-up: Death


Changed on 5/14/2021

VAERS ID: 1098902 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-21
Submitted:0000-00-00
Entered:2021-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-21
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: Diabetic, coronary heart disease
Preexisting Conditions: Diabetic, coronary heart disease
Allergies:
Diagnostic Lab Data: Autopsy not done due to known health conditions and no fowl play. Understood that death was likely caused by his Heath issues, but just wanted the death reported in case there are later findings about the vaccines and potential complications.
CDC 'Split Type':

Write-up: Death

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1098902&WAYBACKHISTORY=ON

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