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This is VAERS ID 998544

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 998544
VAERS Form:2
Age:83.0
Sex:Male
Location:Kentucky
Vaccinated:2021-01-13
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Multiple medication
Current Illness: diabetes, heart trouble, dementia
Preexisting Conditions: as above
Allergies: Morphine and iodine
Diagnostic Lab Data: Stents placed.
CDC 'Split Type':

Write-up: Patient had heart attack. Spoke with spouse on 2/3/2021 stated had multiple health issues including heart and lung issues.


Changed on 5/7/2021

VAERS ID: 998544 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:Kentucky
Vaccinated:2021-01-13
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Multiple medication
Current Illness: diabetes, heart trouble, dementia
Preexisting Conditions: as above
Allergies: Morphine and iodine iodine
Diagnostic Lab Data: Stents placed.
CDC 'Split Type':

Write-up: Patient had heart attack. Spoke with spouse on 2/3/2021 stated had multiple health issues including heart and lung issues.


Changed on 5/14/2021

VAERS ID: 998544 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:Kentucky
Vaccinated:2021-01-13
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Multiple medication
Current Illness: diabetes, heart trouble, dementia
Preexisting Conditions: as above
Allergies: Morphine and iodine iodine
Diagnostic Lab Data: Stents placed.
CDC 'Split Type':

Write-up: Patient had heart attack. Spoke with spouse on 2/3/2021 stated had multiple health issues including heart and lung issues.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=998544&WAYBACKHISTORY=ON

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