Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||006D21A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Chills, Death, Pain in extremity, Pyrexia
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: Lisinopril 40mg daily
Current Illness: None
Preexisting Conditions: High blood pressure
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166