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This is VAERS ID 1355014

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1355014
VAERS Form:2
Age:92.0
Sex:Female
Location:Missouri
Vaccinated:2021-02-01
Onset:2021-05-26
Submitted:0000-00-00
Entered:2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cerebrovascular accident, Condition aggravated, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-26
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: apixaban, morphine, lorazapam, cholecalciferol, bisacodyl
Current Illness: Stroke, a fib, heart failure, HTN, dementia, depression,
Preexisting Conditions: Stroke, A fib, occlusion l. corotid artery, HTN, dementia, depression
Allergies: NSAIDS
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient on hospice d/t Stroke. She had a history of CVA''s. She died 5-26-2021.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1355014&WAYBACKHISTORY=ON

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