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This is VAERS ID 998228

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 998228
VAERS Form:2
Age:65.0
Sex:Male
Location:Michigan
Vaccinated:2021-01-29
Onset:2021-02-03
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: 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: ALBUTEROL HFA (8.5GM) 90 MCG INHA TAKE 1-2 PUFFS INHALATION EVERY 4 TO 6 HOURS AS NEEDED APAP 325MG TABS one (1) to two (2) tabs By Mouth two times daily as needed CALCIUM CARB (150) 500 MG CHEW TAKE 1-2 TABS BY MOUTH THREE TIMES DAILY AS
Current Illness: COPD Gastro-espohageal reflux Osteoarthritis Essential Hypertension Dermatitis COVID-19
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Found unresponsive

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=998228&WAYBACKHISTORY=ON


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