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This is VAERS ID 1737314

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First Appeared on 10/1/2021

VAERS ID: 1737314
VAERS Form:2
Age:93.0
Sex:Female
Location:California
Vaccinated:2021-01-27
Onset:2021-01-30
Submitted:0000-00-00
Entered:2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Blood pressure decreased, Malaise, Blood test abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-10
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: My mom had COVID-19 in December 2020 and was determined to be "out of danger" on 12/16. She had had a dry cough on 12/3, and a PCR test returned positive on that day. I believe she had loss of taste a day or two before 12/3. My mom was put on oxygen support during her COVID-19 illness. This was very unusual for my mom to require oxygen.
Preexisting Conditions: My mother had many long-standing health conditions, however none of them were related to respiratory issues or required her to be on oxygen.
Allergies:
Diagnostic Lab Data: See #18.
CDC 'Split Type':

Write-up: On Jan. 30, 2021, my mom''s blood pressure dropped, she was placed on oxygen support, and a blood panel indicated elevated risk of blood clotting. This was shortly after receiving a dose of Moderna COVID vaccine on or about Jan. 27. These symptoms seemed very similar to what she had experienced in December when she contracted COVID.

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