Adverse Event Reporting
| VAERS ID | 1160669 |
|---|---|
| Gender | Female |
| Age | 81 |
| StateCode | IL |
| Pharmaceutical Company | MODERNA |
| Lot Number | 040A21A |
| Number of vaccinations | 2 |
| Vaccinated | 2021-03-08 |
| Onset | 2021-03-09 |
| Condition | Died |
Symptoms
- Pyrexia
- Chills
- Pain
- Asthenia
Current Illness
none
Preexisting Conditions
Cardiovascular, Diabetes, Respiratory,
Other Medications
coreg 6.25mg, Entresto 25/26 mg, Xarelto 2.5mg, Furosemide 20mg, Methimazole 5mg, Glipizide 10mg, Januvia 50mg, Pepdid 40mg
Previous Vaccinations
Allergies
none
Laboratory Data
Write-up
Fever, Weakness, Chills, Body aches Stared on 3/9/21