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This is VAERS ID 1124826

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1124826
VAERS Form:2
Age:83.0
Sex:Male
Location:Illinois
Vaccinated:2021-02-26
Onset:2021-02-27
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cerebral haemorrhage, Cerebrovascular accident, Death, Transient ischaemic attack, Computerised tomogram head, Magnetic resonance imaging head

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Mini Stroke (TIA) following 1st vaccine
Other Medications: Plavix, Atenolol 50mg, Rosuvastin Calcium 5mg, Tamsulosin 4mg, and Aspirin 81mg
Current Illness: None
Preexisting Conditions: Taking Atenolol for blood pressure.
Allergies: None
Diagnostic Lab Data: Head CTs and MRIs on January 22nd following the 1st vaccine and again February 28th following the 2nd vaccine.
CDC 'Split Type':

Write-up: Patient had a mini stroke (TIA) approximately 14 hours after the 1st Moderna COVID vaccine which is when the doctors put him on Plavix, the blood thinner and an aspirin. The patient had a massive stroke with brain hemorrhage within 24 hours of the 2nd Moderna COVID vaccine which resulted in his death.


Changed on 5/7/2021

VAERS ID: 1124826 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:Illinois
Vaccinated:2021-02-26
Onset:2021-02-27
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cerebral haemorrhage, Cerebrovascular accident, Death, Transient ischaemic attack, Computerised tomogram head, Magnetic resonance imaging head

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Mini Stroke (TIA) following 1st vaccine
Other Medications: Plavix, Atenolol 50mg, Rosuvastin Calcium 5mg, Tamsulosin 4mg, and Aspirin 81mg
Current Illness: None
Preexisting Conditions: Taking Atenolol for blood pressure.
Allergies: None None
Diagnostic Lab Data: Head CTs and MRIs on January 22nd following the 1st vaccine and again February 28th following the 2nd vaccine.
CDC 'Split Type':

Write-up: Patient had a mini stroke (TIA) approximately 14 hours after the 1st Moderna COVID vaccine which is when the doctors put him on Plavix, the blood thinner and an aspirin. The patient had a massive stroke with brain hemorrhage within 24 hours of the 2nd Moderna COVID vaccine which resulted in his death.


Changed on 5/14/2021

VAERS ID: 1124826 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:Illinois
Vaccinated:2021-02-26
Onset:2021-02-27
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cerebral haemorrhage, Cerebrovascular accident, Death, Transient ischaemic attack, Computerised tomogram head, Magnetic resonance imaging head

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Mini Stroke (TIA) following 1st vaccine
Other Medications: Plavix, Atenolol 50mg, Rosuvastin Calcium 5mg, Tamsulosin 4mg, and Aspirin 81mg
Current Illness: None
Preexisting Conditions: Taking Atenolol for blood pressure.
Allergies: None None
Diagnostic Lab Data: Head CTs and MRIs on January 22nd following the 1st vaccine and again February 28th following the 2nd vaccine.
CDC 'Split Type':

Write-up: Patient had a mini stroke (TIA) approximately 14 hours after the 1st Moderna COVID vaccine which is when the doctors put him on Plavix, the blood thinner and an aspirin. The patient had a massive stroke with brain hemorrhage within 24 hours of the 2nd Moderna COVID vaccine which resulted in his death.

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