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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1171191



Case Details

VAERS ID: 1171191 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-03-31
Onset:2021-04-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olanzapine, metformin, albuterol, atorvastatin, omeprazole
Current Illness:
Preexisting Conditions: Diabetes, schizophrenia, GERD
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was found dead in his apartment. I''m not clear on details, but he was having some issues the week prior to being vaccinated. He was in acute distress when his attendant care worker came to give him his medications the day before.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1171191

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