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This is VAERS ID 1002229

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 1002229
VAERS Form:2
Age:77.0
Sex:Male
Location:Minnesota
Vaccinated:2021-01-22
Onset:2021-02-03
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-03
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: unknown
Current Illness: none known
Preexisting Conditions: CAD with stent placement 2000
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: spontaneous death, found unresponsive in cell after normal morning activities

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1002229&WAYBACKHISTORY=ON


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