Report #2828057

Received Feb 25, 2025

DiedLife-threatening

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Female
Age: 87 yrs
State: ME
Recovered: Not recovered
Vaccinated: Dec 16, 2021
Onset: Dec 16, 2021
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	031H21A	SYR / UN

Symptoms (3)

DeathMyocardial infarctionThrombosis

Symptom narrative

clot developed causing fatal heart attack

Current illness

none

Medical history

none

Other medications

none

Allergies

none

Lab data

4/18/23