Adverse Event Reporting

VAERS ID 2095933
Gender Female
Age 83
StateCode
Pharmaceutical Company MODERNA
Lot Number 046C21A
Number of vaccinations 3
Vaccinated 2021-02-11
Onset 2022-01-25
Condition Hospitalized
Symptoms
  • SARS-CoV-2 test positive
  • COVID-19
  • Vaccine breakthrough infection

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

1/25/2022 COVID +

Write-up

Event occurred after 3rd vaccine; breakthrough case