Adverse Event Reporting
| VAERS ID | 1155464 |
|---|---|
| Gender | Female |
| Age | 86 |
| StateCode | IL |
| Pharmaceutical Company | MODERNA |
| Lot Number | 038K20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-02-05 |
| Onset | 2021-02-08 |
| Condition | Died |
Symptoms
- Death
Current Illness
Fluid overload, shortness of breath (hospitalized 1/27)
Preexisting Conditions
hypertension, hyperlipidemia, heart failure, afib, hyperparathyroidism, osteopenia, osteoarthritis, osteodystrophy, anemia, renal dysfunction, CKD end stage, fluid overload
Other Medications
Norco, Metoprolol XL, Famotidine, midodrine, Calcitonin, Pravastatin, Raloxifene
Previous Vaccinations
Allergies
no known allergies
Laboratory Data
Write-up
Patient passed away 2/23/21