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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||046AZ1A / 2||- / IM|
Administered by: Public Purchased by: ??
Symptoms: Death, Dyspnoea, Epistaxis, Mouth haemorrhage, Pyrexia
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: High Cholesterol
Diagnostic Lab Data: Unknown
CDC 'Split Type': CA134B1001
Write-up: On Friday night, 3/19/21, patient spiked a fever, had shortness of breath, and had blood coming out of his nose and mouth per patient''s daughter-in law. 9-1-1 was called, paramedics arrived at the home at 5AM on Saturday, 3/20/21 per patient''s daughter. Patient died.
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