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This is VAERS ID 1361857

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1361857
VAERS Form:2
Age:60.0
Sex:Female
Location:Tennessee
Vaccinated:2021-04-26
Onset:2021-04-26
Submitted:0000-00-00
Entered:2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B12A / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Fatigue, Lethargy, Migraine

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: OxyContin, oxycodiene, lyrica, goody powders, premarin
Current Illness: Migraines, lethargic and tired
Preexisting Conditions: Carpal tunnel, slipped herniated discs, osteoporosis, arthritis
Allergies: Morphine, gabapentin
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: DEATH, lethargic, migraines, tired

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1361857&WAYBACKHISTORY=ON

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