National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1756876

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1756876
VAERS Form:2
Age:69.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-10
Onset:2021-09-17
Submitted:0000-00-00
Entered:2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Fall, Fracture, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-09-23
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: Norco, duloxetine, midodrine, melatonin, calcium carbonate, amitriptyline, senna, lidocaine, nitrofurantoin, nystain,
Current Illness: depression, iron deficiency, repeated falls, constipation, dementia
Preexisting Conditions: dementia, anemia, depression
Allergies: morphine
Diagnostic Lab Data: Abbot rapid nasal covid swab on 09/17/2021 X 2, both with + results
CDC 'Split Type':

Write-up: Received covid vaccine at another (unknown) location prior to admission to facility. experienced multiple falls with significant fractures (prior to facility admission), which put her in the hospital, then needing rehab. transferred to this facility, facility sent to the hospital r/t medical concerns on 09/05/2021, returned to the facility on 09/10/2021, tested positive for covid 19 on 09/17/2021. was treated per facility APRN and MD, however, despite efforts, expired on 09/23/2021. Death is under investigation with health department for cause.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1756876&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166