Adverse Event Reporting
| VAERS ID | 930154 |
|---|---|
| Gender | Male |
| Age | 60 |
| StateCode | OH |
| Pharmaceutical Company | MODERNA |
| Lot Number | 039K2020A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-05 |
| Onset | 2021-01-08 |
| Condition | Died |
Symptoms
- Death
Current Illness
unkown
Preexisting Conditions
unknown
Other Medications
unknown
Previous Vaccinations
Allergies
Sulfa
Laboratory Data
Write-up
Notified today that he passed away.
No other details known at this time.