Adverse Event Reporting

VAERS ID 922977
Gender Male
Age 71
StateCode NY
Pharmaceutical Company MODERNA
Lot Number 011J20A
Number of vaccinations 2
Vaccinated 2020-12-21
Onset 2020-12-27
Condition Died
Symptoms
  • Pyrexia
  • SARS-CoV-2 test positive
  • Respiratory depression

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

Fever, RespDepression & COVID positive REMDESIVIR (EUA) 200 mg x1 then 100 mg daily