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This is VAERS ID 1132062

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1132062
VAERS Form:2
Age:56.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-18
Onset:2021-03-22
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1132062&WAYBACKHISTORY=ON


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