Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||- / 1||RA / IM|
Administered by: Senior Living Purchased by: ??
Symptoms: Asthenia, Condition aggravated, Death, Decreased appetite, COVID-19, SARS-CoV-2 test positive
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: Pepcid, Aspirin, DOK Plus, Miralax, Potassium Chloride ER, Vitamin C, Ensure Clear, Metoprolol Tartrate, Tramadol, Artificial Tears,
Preexisting Conditions: OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBAR REGION, Macular Degeneration, Anorexia, Peripheral Vascular Disease, Cardiac Arrhythmia,
Allergies: No known allergies
Diagnostic Lab Data: COVID-19 PCR test positive on 1-28-21
CDC 'Split Type':
Write-up: Resident received the vaccine on 1-22-21 and she was diagnosed with COVID-19 during routine testing on 1-28-21. She didn''t have any symptoms except feeling weak and she had a decrease in her appetite. She already had a poor appetite prior. She died on 2-2-21.
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166