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This is VAERS ID 1337689

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1337689
VAERS Form:2
Age:68.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-26
Onset:2021-05-21
Submitted:0000-00-00
Entered:2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-21
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: Crestor, Trazadone, Lexapro, Seroquel
Current Illness:
Preexisting Conditions: Severe arthritis, vision problems, depression, high cholesterol
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Health district notified by Police Dept. that a homebound resident who received first dose of Moderna on 4/26/21 and was due for second dose moderna on 5/24/21 was found deceased at home on 5/21/21.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1337689&WAYBACKHISTORY=ON

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