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

This is VAERS ID 1228018



Case Details

VAERS ID: 1228018 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-19
Onset:2021-03-28
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Death, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deceased 3/28/21 "natural causes" Narrative: Per notes "Pathologist was informed that he died of natural causes". PCP indicated that death cert will only show HTN as cause of death.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1228018

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