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This is VAERS ID 922977

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 1/7/2021

VAERS ID: 922977
VAERS Form:1
Age:71.0
Sex:Male
Location:New York
Vaccinated:2020-12-21
Onset:2020-12-27
Submitted:2020-12-28
Entered:2021-01-05
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 2 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Pyrexia, Respiratory depression, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-12-28
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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

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