Adverse Event Reporting
| VAERS ID | 1454169 |
|---|---|
| Gender | Female |
| Age | 75 |
| StateCode | NJ |
| Pharmaceutical Company | MODERNA |
| Lot Number | |
| Number of vaccinations | |
| Vaccinated | 2021-06-22 |
| Onset | 2021-06-22 |
| Condition | Hospitalized Died |
Symptoms
- Death
Current Illness
Heart Surgery May 18th
Preexisting Conditions
None
Other Medications
None
Previous Vaccinations
Allergies
None
Laboratory Data
Contact Hospital
Write-up
Death