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This is VAERS ID 953348

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 953348
VAERS Form:2
Age:81.0
Sex:Male
Location:Arkansas
Vaccinated:2020-12-22
Onset:2020-12-24
Submitted:0000-00-00
Entered:2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-14
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: Atorvastatin, Ibuprofen, Oxybutinin, Morphine Sulfate
Current Illness:
Preexisting Conditions: Chronic pain, high blood pressure
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient was living in a nursing home with positive cases when administered. His age and chronic condition was such that he did not have time after the vaccination to avoid exposure or develop immunity.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=953348&WAYBACKHISTORY=ON


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