Adverse Event Reporting
| VAERS ID | 917117 |
|---|---|
| Gender | Male |
| Age | 82 |
| StateCode | AR |
| Pharmaceutical Company | MODERNA |
| Lot Number | |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-22 |
| Onset | 2020-12-28 |
| Condition | Died |
Symptoms
- SARS-CoV-2 test positive
- COVID-19
- Death
Current Illness
Yes
Preexisting Conditions
Yes
Other Medications
Quietapine, Mertazipine, Hydrocodone, Fentanyl
Previous Vaccinations
Allergies
None
Laboratory Data
COVID-19 positive test approximately one week after vaccination.
There is no evidence to support that the vaccine caused his death in any way.
Write-up
After vaccination, patient tested positive for COVID-19.
Patient was very ill and had numerous chronic health issues prior to vaccination.
Facility had a number of patients who had already tested positive for COVID-19.
Vaccination continued in an effort to prevent this patient from contracting the virus or to mitigate his risk.
This was unsuccessful and patient died.