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This is VAERS ID 1582850

History of Changes from the VAERS Wayback Machine

First Appeared on 8/20/2021

VAERS ID: 1582850
VAERS Form:2
Age:92.0
Sex:Female
Location:Mississippi
Vaccinated:2021-08-11
Onset:2021-08-12
Submitted:0000-00-00
Entered:2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Respiratory distress, Unresponsive to stimuli, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-12
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA ATIVAN LORAZEPAM SEROQUEL ZOLOFT LASIX TRAZODONE LOPRESSOR VITANMIN D NAMENDA DIGOXIN
Current Illness: UTI ALZHEIMERS CELLULITIS ATRIAL FIB SICK SINUS SYNDROME ANXIETY MAJOR DEPRESSIVE D/O PSYCHOTIC D/O WITH DELUSIONS HTN RESTLESSNESS/AGITATION CONSTIPATION
Preexisting Conditions: UTI ALZHEIMERS CELLULITIS ATRIAL FIB SICK SINUS SYNDROME ANXIETY MAJOR DEPRESSIVE D/O PSYCHOTIC D/O WITH DELUSIONS HTN RESTLESSNESS/AGITATION CONSTIPATION
Allergies: NKDA
Diagnostic Lab Data: UNKNOWN
CDC 'Split Type':

Write-up: 8/12/21 @ 03:37 AM - PT NOTED TO HAVE EMESIS ON SHEETS AND GOWN. RESPONSIVE, VITALS STABLE, MD AND FAMILY NOTIFIED, ZOFRAN ORDERED AND GIVEN. NO DISTRESS NOTED. 8/12/21 @ 09:55 AM - PT NOTED TO BE EATING BREAKFAST. NO DISTRESS NOTED. 8/12/21 @ 8:50 PM - VOMITING, NON-RESPONSIVE, RESPIRATORY DISTRESS. 02 SATS 48-50%. AMBULANCE CALLED, PT TAKEN TO ER. 8/12/21 @ 8:58 PM - FACILITY NOTIFIED THAT RESIDENT EXPIRED.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1582850&WAYBACKHISTORY=ON

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