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

This is VAERS ID 1337634



Case Details

VAERS ID: 1337634 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-16
   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: Levothyroxin Valium Multi vitamin Coreg Lisinopril Protonix Asprin Mecline Lipitor
Current Illness: None.
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: ?

Write-up: had second dose on 5/14/21, passed away during the night of 5/15/21. Found dead on 5/16/21 morning


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1337634

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