Adverse Event Reporting
| VAERS ID | 2184159 |
|---|---|
| Gender | Female |
| Age | 79 |
| StateCode | |
| Pharmaceutical Company | MODERNA |
| Lot Number | 022C21A |
| Number of vaccinations | 3 |
| Vaccinated | 2021-11-09 |
| Onset | 2022-01-16 |
| Condition | Hospitalized Died |
Symptoms
- Death
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
VAERS reporting as required by law, death occurred on 01/16/2022.
Moderna COVID 19 vaccines completed on 2/9/2021, 3/9/2021, 11/9/2021.