Adverse Event Reporting
| VAERS ID | 2171253 |
|---|---|
| Gender | Female |
| Age | 83 |
| StateCode | TN |
| Pharmaceutical Company | MODERNA |
| Lot Number | 011M20A |
| Number of vaccinations | 2 |
| Vaccinated | 2021-01-30 |
| Onset | 2021-09-11 |
| Condition | Died |
Symptoms
- SARS-CoV-2 test positive
- COVID-19
- COVID-19 pneumonia
- Death
- Cognitive disorder
- Aggression
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
pt in SNF with neurocognitive decline; history of a positive COVID test on 9/11/21 with history of COVID pneumonia; was transferred from another SNF to this one due to aggressive behavior towards staff; very little information in medical record; pt passed away in the SNF