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This is VAERS ID 1346657

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1346657
VAERS Form:2
Age:19.0
Sex:Male
Location:Louisiana
Vaccinated:2021-02-18
Onset:2021-02-19
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Arrhythmia, Blood immunoglobulin E increased, Death, Seizure, Autopsy, Toxicologic test, Histology, Tryptase, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-19
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: Clonidine, Vyvanse, Vraylor
Current Illness: none
Preexisting Conditions: Autism and ADHD
Allergies:
Diagnostic Lab Data: Autopsy with histology, toxicology, postmortem Covid-19 PCR test negative, post mortem Tryptase normal and elevated elevated IgE, cause and manner of death undetermined, Covid-19 not suspected cause, suspected cause heart arrhythmia (family history, history of chest pain, and medications) or seizure.
CDC 'Split Type':

Write-up: Found deceased in bed, no known symptoms, undetermined cause and manner of death

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