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

This is VAERS ID 928513

Government Disclaimer on use of this data

Case Details

VAERS ID:	928513 (history)
Form:	Version 2.0
Age:	72.0
Sex:	Female
Location:	Michigan

Vaccinated:	2021-01-05
Onset:	2021-01-06
Days after vaccination:	1
Submitted:	0000-00-00
Entered:	2021-01-08

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA	026L20A / 1	RA / IM

Administered by: Senior Living Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-06
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amiodarone Hcl, Carvedilol, Ferrous sulfate, Eliquis (cont)
Current Illness: Atrial fibrillation, Anemia, 1st degree AV block, CDK stage 4,
Preexisting Conditions: CDK stage 4, Atrial fibrillation, 1st degree AV block, Patient was under hospice care
Allergies: Aldactone, contrast dye
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Resident passed away in her sleep

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