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This is VAERS ID 981406

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 981406
VAERS Form:2
Age:71.0
Sex:Female
Location:Tennessee
Vaccinated:2021-01-15
Onset:2021-01-18
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cerebrovascular accident, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-18
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: multiple, unknown
Current Illness:
Preexisting Conditions: COPD, smoker
Allergies: unknown
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Stroke, death


Changed on 5/7/2021

VAERS ID: 981406 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Tennessee
Vaccinated:2021-01-15
Onset:2021-01-18
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cerebrovascular accident, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-18
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: multiple, unknown
Current Illness:
Preexisting Conditions: COPD, smoker
Allergies: unknown unknown
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Stroke, death


Changed on 5/21/2021

VAERS ID: 981406 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:Tennessee
Vaccinated:2021-01-15
Onset:2021-01-18
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cerebrovascular accident, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-18
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: multiple, unknown
Current Illness:
Preexisting Conditions: COPD, smoker
Allergies: unknown unknown
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Stroke, death

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