이상반응 보고
| VAERS ID | 914621 |
|---|---|
| 성별 | 여성 |
| 나이 | 89세 |
| 주 코드 | IA |
| 제약회사 | MODERNA |
| 로트 번호 | 011J02A |
| 예방접종 횟수 | 1 |
| 접종일 | 2020-12-22 |
| 발병일 | 2020-12-27 |
| 상태 | 사망 |
증상
- 피로(Fatigue)
- 죽음(Death)
- 백치(Dementia)
이환 중 질병
None
지병
Resident in long term care facility for 9+ years Coronary Artery Disease Dementia Hypothyroidism Hypertension
기타 의료
이전 예방접종
알레르기
임상 검사
증상 상세
Resident in our long term care facility who received first dose of Moderna COVID-19 Vaccine on 12/22/2020, only documented side effect was mild fatigue after receiving.
She passed away on 12/27/2020 of natural causes per report.
Has previously been in & out of hospice care, resided in nursing home for 9+ years, elderly with dementia.
Due to proximity of vaccination we felt we should report the death, even though it is not believed to be related.