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

This is VAERS ID 1180530



Case Details

VAERS ID: 1180530 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Basal ganglia haemorrhage, Death
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: buproprion SR 150mg pentoxyfilline ER 400mg furosemide 20mg aspirin 81mg protonix 40mg citalopram 40mg hydrochlorothiazide 12.5mg pravastatin 40mg myrbetriq ER 25mg vitamin D Vitamin C B-super complex vitamin E multivitamin calcium glucosam
Current Illness: none
Preexisting Conditions: normal pressure hydrocephalus with VP shunt osteoporosis kidney disease, stage 3
Allergies: codeine (nausea & vomiting)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Death due to massive basal ganglia hemorrhage


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1180530

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