Adverse Event Reporting
| VAERS ID | 930910 |
|---|---|
| Gender | Female |
| Age | 52 |
| StateCode | HI |
| Pharmaceutical Company | MODERNA |
| Lot Number | 012L20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-08 |
| Onset | 2021-01-08 |
| Condition | Died |
Symptoms
- Death
Current Illness
None
Preexisting Conditions
Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side, major depressive disorder, aphasia following cerebral infarction, muscle weakness, dysphagia, hypothyrodism, type 2 diabetes, hyperlipidemia, hypomagnesemia, hypokalemia, hypertension, gastro esophageal reflux disease, gastritis, constipation
Other Medications
Patient was refusing to take all medications for over a year
Previous Vaccinations
Allergies
Metformin, morphine, statins, latex
Laboratory Data
Write-up
Patient received COVID vaccination around 12:15pm.
Patient was monitored for the appropriate amount of time by nursing staff.
Patient passed away at 2:15pm.