VAERS Explorer
Back to explore

Report #2825515

Received Feb 10, 2025

Died
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
Male
Age
93 yrs
State
IA
Recovered
Not recovered
Vaccinated
Oct 24, 2024
Onset
Feb 9, 2025
Days to onset
108
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA7+3043159IM / RA

Symptoms (1)

Death

Symptom narrative

Death

Medical history

E11.42 TYPE 2 DIABETES MELLITUS WITH DIABETIC POLYNEUROPATHY NTA (2 pts) Medical Management 12/16/2024 Primary Diagnosis (#67) 12/19/2024 update C I26.99 OTHER PULMONARY EMBOLISM WITHOUT ACUTE COR PULMONALE Cardiovascular and Coagulations 2/7/2025 Diagnosis Rank Insignificant 2/7/2025 update C I82.492 ACUTE EMBOLISM AND THROMBOSIS OF OTHER SPECIFIED DEEP VEIN OF LEFT LOWER EXTREMITY Cardiovascular and Coagulations 2/7/2025 Diagnosis Rank Insignificant 2/7/2025 update C R13.12 DYSPHAGIA, OROPHARYNGEAL PHASE N/A, not an acceptable Primary Diagnosis 1/28/2025 Diagnosis Rank Insignificant 1/29/2025 update C Z79.4 LONG TERM (CURRENT) USE OF INSULIN N/A, not an acceptable Primary Diagnosis 12/16/2024 Diagnosis Rank Insignificant 12/19/2024 update C B37.9 CANDIDIASIS, UNSPECIFIED Medical Management 7/25/2024 Diagnosis Rank Insignificant 7/25/2024 update C N40.1 BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C N13.8 OTHER OBSTRUCTIVE AND REFLUX UROPATHY Medical Management 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C N32.81 OVERACTIVE BLADDER Medical Management 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C G31.84 MILD COGNITIVE IMPAIRMENT OF UNCERTAIN OR UNKNOWN ETIOLOGY N/A, not an acceptable Primary Diagnosis 4/17/2023 Diagnosis Rank Insignificant 4/21/2023 update C F32.A DEPRESSION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/14/2023 Diagnosis Rank Insignificant 1/2/2024 update C M19.041 PRIMARY OSTEOARTHRITIS, RIGHT HAND Non-Surgical Orthopedic/Musculoskeletal 4/14/2023 Diagnosis Rank Insignificant 1/2/2024 update C Z96.1 PRESENCE OF INTRAOCULAR LENS N/A, not an acceptable Primary Diagnosis 4/12/2023 Diagnosis Rank Insignificant 1/2/2024 update C R41.3 OTHER AMNESIA N/A, not an acceptable Primary Diagnosis 4/12/2023 Diagnosis Rank Insignificant 1/2/2024 update C E66.9 OBESITY, UNSPECIFIED Medical Management 4/12/2023 Diagnosis Rank Insignificant 1/2/2024 update C G60.9 HEREDITARY AND IDIOPATHIC NEUROPATHY, UNSPECIFIED Acute Neurologic 4/12/2023 Diagnosis Rank Insignificant 1/2/2024 update C J96.01 ACUTE RESPIRATORY FAILURE WITH HYPOXIA NTA (1 pts) Pulmonary 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C I10 ESSENTIAL (PRIMARY) HYPERTENSION N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C G47.33 OBSTRUCTIVE SLEEP APNEA (ADULT) (PEDIATRIC) Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M16.12 UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT HIP Non-Surgical Orthopedic/Musculoskeletal 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C F41.9 ANXIETY DISORDER, UNSPECIFIED Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M19.90 UNSPECIFIED OSTEOARTHRITIS, UNSPECIFIED SITE N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C E11.40 TYPE 2 DIABETES MELLITUS WITH DIABETIC NEUROPATHY, UNSPECIFIED NTA (2 pts) Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M16.10 UNILATERAL PRIMARY OSTEOARTHRITIS, UNSPECIFIED HIP N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C K59.00 CONSTIPATION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C K21.9 GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C R52 PAIN, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C G47.00 INSOMNIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C R60.9 EDEMA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C E56.9 VITAMIN DEFICIENCY, UNSPECIFIED Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C J44.9 CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED NTA (2 pts) Pulmonary 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M19.049 PRIMARY OSTEOARTHRITIS, UNSPECIFIED HAND N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M19.019 PRIMARY OSTEOARTHRITIS, UNSPECIFIED SHOULDER N/A, not an acceptable Primary Diagnosis 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M43.22 FUSION OF SPINE, CERVICAL REGION Non-Surgical Orthopedic/Musculoskeletal 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C E11.9 TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS NTA (2 pts) Medical Management 4/11/2023 Diagnosis Rank Insignificant Admission 4/11/2023 update C M19.042 PRIMARY OSTEOARTHRITIS, LEFT HAND

Allergies

PCN