VAERS Results 01312021

Vaccine
Manufacturer
Event
Category
Age
VAERS
ID
Adverse Event Description
MODERNA Death 65+ years 958745-1
Resident was noted to have increase weakness on 1/15/2021. Resident was warm to touch with
low grade fever of 99.3 F. Resident was up propelling self in w/c on 1/16/2021 he was pleasant,
accepted medications and ate lunch. He was found slumped over in his w/c not responding and
vital signs absent.
MODERNA Death 65+ years 958935-1 Sudden Death within 24 hours of vaccine
MODERNA Death 65+ years 958971-1 Hemorrhagic Stroke, Right Basal Ganglion
MODERNA Death 65+ years 959167-1 Patient received COVID 19 vaccine 01/14/2021. Patient died in his sleep 01/16/2021.
MODERNA Death 65+ years 959272-1
Patient died 4 days after immunization. Probably unrelated to immunization, as patient has been
in poor health and was receiving hospice services. I have no details related to his illness or
symptoms. Daughter is the HIPAA/emergency contact and will have all the information needed.
MODERNA Death 65+ years 959356-1 Pt passed away the day after the vaccine was given.
MODERNA Death 65+ years 959568-1
Patient received her first dose of the Moderna COVID-19 Vaccination on Saturday January 16th
2021 at approximately 12pm. She completed all necessary screening forms and was deemed to
be at low risk for serious allergic reactions. She tolerated the vaccination well, and no
complications or immediate adverse events occurred. She was observed for a full 15 mins per
CDPHE/CDC guidelines and left the Clinic in stable condition after her observation period was
complete. On the morning of Tuesday, January 19th, 2021, the patient was found unconscious
and unresponsive by her husband. She was transferred by Ambulance to Hospital shortly
thereafter. She was diagnosed with a brain bleed that was determined to be inoperable. She was
transferred to other Hospital for higher level care. She was seen by neurosurgery and diagnosed
with a ruptured aneurysm. She was treated in the ICU for 24 hours, at which point her team
determined that the severity of her brain bleed would not respond to treatment. Supportive
cares were withdrawn on Wednesday Jan 20th, and she passed away shortly thereafter.