Adverse Event Reporting
| VAERS ID | 1269804 |
|---|---|
| Gender | Male |
| Age | 81 |
| StateCode | NJ |
| Pharmaceutical Company | MODERNA |
| Lot Number | |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-29 |
| Onset | 2021-02-08 |
| Condition | Hospitalized Died |
Symptoms
- Contusion
- Epistaxis
Current Illness
n/a
Preexisting Conditions
Congestive heart failure
Other Medications
Warfarin, furosemide
Previous Vaccinations
Allergies
n/a
Laboratory Data
Write-up
nose bleeds, black and blue marks weeks later,