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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||010M20A / 1||LA / IM|
Administered by: Pharmacy Purchased by: ??
Symptoms: Death, Dyspnoea, Hypopnoea, Palpitations
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: OTC APAP prn Tradjenta 5mg daily amlodipine 10mg daily naproxen 500mg BID trazodone 100mg HS atorvastatin 20mg daily gabapentin 100mg TID timolol 0.5% eye drops 1 drop each eye BID metformin ER 500mg daily glipizide 10mg BID lisinopril 20m
Preexisting Conditions: High blood pressure High Cholesterol Diabetes Restless Legs syndrome depression/anxiety
Diagnostic Lab Data: unknown
CDC 'Split Type':
Write-up: Patient had no symptoms or adverse events until the next evening after shot (1/29/21) where daughter reported her having heart palpitations. Family told her to rest and did not seek medical attention. Saturday afternoon (1/30/2021), patient started experiencing labored breathing. Daughter called 911 and before the ambulance arrived, the patient''s breathing became more and more shallow. Patient was taken to the local hospital and passed away Saturday evening around 5:30 pm.
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