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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||030B21A / 2||- / IM|
Administered by: Public Purchased by: ??
Symptoms: Death, Dyspnoea, Headache, Nausea, Vomiting, COVID-19, COVID-19 pneumonia
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Htn, GERD, Type 2 DM, COPD, ESRD, CHF, Afib
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Write-up: Patient received second COVId 19 vaccine on 4/9/21 @ Health Department. Was admitted to hospital on 5/18/2021 with SOB, Nausea, Vomiting, and Headache. Diagnosed with COVID 19 infection and COVID 19 Pneumonia. Patient expired on 5/19/2021 at hospital.
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