Adverse Event Reporting
| VAERS ID | 1289756 |
|---|---|
| Gender | Female |
| Age | 86 |
| StateCode | PA |
| Pharmaceutical Company | MODERNA |
| Lot Number | 021B21A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-04-05 |
| Onset | 2021-04-24 |
| Condition | Died |
Symptoms
- Death
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
no known allergies
Laboratory Data
Write-up
Patient passed away before receiving second dose, husband states not COVID related death.