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This is VAERS ID 1359313

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1359313
VAERS Form:2
Age:66.0
Sex:Male
Location:New Jersey
Vaccinated:2021-01-14
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM

Administered by: School      Purchased by: ??
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Death, Mechanical ventilation, Computerised tomogram head abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-06
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tacrolimus, Myfortic, Prednisone, Bactrim, Omeprazole, Metoprolol, Tamsulosin, Vytorin, Amlodlpine, Calcitriol, Jadiance, Humalog, Lantas, Trulicity, Fish Oil, Aspirin, Multivitamin
Current Illness: none
Preexisting Conditions: diabetic high blood pressure Kidney Transplant
Allergies: none
Diagnostic Lab Data: Many CT scans and other test. I do not have the record to know exactly all the procedures that were done.
CDC 'Split Type':

Write-up: My husband had a stroke on 01/25/2021, with one large blood clot and many small blood clots. He was put on a ventilator until 02/06/2021 when I asked to have it removed. I died within 5 minutes after it being removed.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1359313&WAYBACKHISTORY=ON

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