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This is VAERS ID 1256806

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1256806
VAERS Form:2
Age:58.0
Sex:Female
Location:Florida
Vaccinated:2021-03-25
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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: Bystolic Quinapril Chlortalidone Atorvastatin Fenofibrate
Current Illness:
Preexisting Conditions: HTN, DM
Allergies: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My Sister was found dead on 4/27/2021. She had been dead aprx. 0ne week. She received her 1st Moderna shot on March 25th.


Changed on 5/7/2021

VAERS ID: 1256806 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:Florida
Vaccinated:2021-03-25
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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: Bystolic Quinapril Chlortalidone Atorvastatin Fenofibrate
Current Illness:
Preexisting Conditions: HTN, DM
Allergies: Sulfa Sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My Sister was found dead on 4/27/2021. She had been dead aprx. 0ne week. She received her 1st Moderna shot on March 25th.


Changed on 5/14/2021

VAERS ID: 1256806 Before After
VAERS Form:2
Age:58.0
Sex:Female
Location:Florida
Vaccinated:2021-03-25
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-17
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: Bystolic Quinapril Chlortalidone Atorvastatin Fenofibrate
Current Illness:
Preexisting Conditions: HTN, DM
Allergies: Sulfa Sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My Sister was found dead on 4/27/2021. She had been dead aprx. 0ne week. She received her 1st Moderna shot on March 25th.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1256806&WAYBACKHISTORY=ON


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