From the 4/26/2024 release of VAERS data:

This is VAERS ID 925154

Government Disclaimer on use of this data

Case Details

VAERS ID:	925154 (history)
Form:	Version 2.0
Age:	84.0
Sex:	Female
Location:	Florida

Vaccinated:	2021-01-03
Onset:	2021-01-04
Days after vaccination:	1
Submitted:	0000-00-00
Entered:	2021-01-07

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA	- / UNK	- / -

Administered by: Public Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-04
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Avorstatin Aspirin Oxycodone
Current Illness: NONE
Preexisting Conditions: COPD
Allergies: None
Diagnostic Lab Data: Hospital
CDC Split Type:

Write-up: Deceased

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=925154