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This is VAERS ID 1554013

History of Changes from the VAERS Wayback Machine

First Appeared on 8/20/2021

VAERS ID: 1554013
VAERS Form:2
Age:69.0
Sex:Female
Location:Unknown
Vaccinated:2021-06-18
Onset:2021-08-09
Submitted:0000-00-00
Entered:2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-09
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient died on August 9, 2021.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1554013&WAYBACKHISTORY=ON

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