Adverse Event Reporting
| VAERS ID | 925264 |
|---|---|
| Gender | Male |
| Age | 77 |
| StateCode | OK |
| Pharmaceutical Company | MODERNA |
| Lot Number | 025L20A |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-31 |
| Onset | |
| Condition | Died |
Symptoms
- Death
Current Illness
CHF HTN DM 2 CKD Obesity DDD
Preexisting Conditions
CHF HTN DM 2 CKD Obesity DDD
Other Medications
Norco 5/325 1 tablet every 6 hours as needed. Warfarin 4mg , 2 tablets orally Monday and Friday Torsemide 100mg, 1/2 tablet orally once a day Sabcubitril-Valsartan 24/26mg 1/4 tablet orally twice a day Gabapentin 300mg, tablet once daily Ca
Previous Vaccinations
Allergies
NKDA
Laboratory Data
None
Write-up
PT was found deceased in his home on 1/5/2021