Report #2825516

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: Female
Age: 75 yrs
State: IA
Recovered: Not recovered
Vaccinated: Jul 1, 2021
Onset: Feb 8, 2025
Days to onset: 1318
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	038C21S	IM / LA

Symptoms (1)

Death

Symptom narrative

Death

Medical history

F03.90 UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY Medical Management 3/27/2024 Primary Diagnosis (#67) 3/27/2024 update C F32.A DEPRESSION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 5/16/2024 Diagnosis Rank Insignificant 5/16/2024 update C F41.9 ANXIETY DISORDER, UNSPECIFIED Medical Management 3/28/2024 Diagnosis Rank Insignificant 7/3/2024 update C E55.9 VITAMIN D DEFICIENCY, UNSPECIFIED Medical Management 3/28/2024 Diagnosis Rank Insignificant 7/3/2024 update C M17.0 BILATERAL PRIMARY OSTEOARTHRITIS OF KNEE Non-Surgical Orthopedic/Musculoskeletal 3/28/2024 Diagnosis Rank Insignificant 7/3/2024 update C K21.9 GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS N/A, not an acceptable Primary Diagnosis 3/28/2024 Diagnosis Rank Insignificant 10/7/2024 update C K57.30 DIVERTICULOSIS OF LARGE INTESTINE WITHOUT PERFORATION OR ABSCESS WITHOUT BLEEDING Medical Management 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C E11.69 TYPE 2 DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATION NTA (2 pts) Medical Management 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C E66.9 OBESITY, UNSPECIFIED Medical Management 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C R00.1 BRADYCARDIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C I15.9 SECONDARY HYPERTENSION, UNSPECIFIED Cardiovascular and Coagulations 3/27/2024 Diagnosis Rank Insignificant 3/27/2024 update C I25.10 ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS

Allergies

Cephalexin, Cholestyramine, Codeine, Colesevelam, Colestipol, Diclofenac, Glimepiride, Levothyroxine, Lisinopril, metFORMIN, metroNIDAZOLE, Omeprazole, Penicillin, Pravastatin, Rosuvastatin, Simvastatin, traZODone, Bupropion, Spironolactone