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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1132062



Case Details

VAERS ID: 1132062 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-03-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypophagia
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-22
   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: Ativan and Morphine- per Hospice orders
Current Illness: Patient had been admitted to Hospice prior to her first dose of the vaccine. She had been decompensating for many months prior.
Preexisting Conditions: COPD, Emphysema, hypertension, seizure disorder, anemia, schizoaffective disorder, bordeline personality disorder,
Allergies: Lithium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had multiple hospitalizations for COPD prior to COVID-19 infection in December 2020. Had been admitted to Hospice for further decompensation after COVID diagnosis. Limited oral intake and hospice began using morphine and Ativan. Was on comfort medications only prior to 1/26/2021


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1132062

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