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Report #2825552

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
73 yrs
State
IA
Recovered
Not recovered
Vaccinated
Oct 17, 2024
Onset
Feb 10, 2025
Days to onset
116
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA7+3043332IM / LA

Symptoms (1)

Death

Symptom narrative

Death

Medical history

F03.918 UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE Medical Management 4/24/2023 Primary Diagnosis (#67) 4/24/2023 update C R19.7 DIARRHEA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 1/25/2024 Diagnosis Rank Insignificant 1/25/2024 update C R06.02 SHORTNESS OF BREATH N/A, not an acceptable Primary Diagnosis 1/8/2024 Diagnosis Rank Insignificant 1/8/2024 update C J44.9 CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED NTA (2 pts) Pulmonary 12/25/2023 Diagnosis Rank Insignificant 12/25/2023 update C E87.5 HYPERKALEMIA Medical Management 10/19/2023 Diagnosis Rank Insignificant 10/19/2023 update C Z20.822 CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-19 N/A, not an acceptable Primary Diagnosis 10/13/2023 Diagnosis Rank Insignificant 10/13/2023 update C E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 5/25/2023 Diagnosis Rank Insignificant 5/25/2023 update C E11.9 TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS NTA (2 pts) Medical Management 5/25/2023 Diagnosis Rank Insignificant 5/25/2023 update C G31.1 SENILE DEGENERATION OF BRAIN, NOT ELSEWHERE CLASSIFIED Medical Management 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F25.0 SCHIZOAFFECTIVE DISORDER, BIPOLAR TYPE Medical Management 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F31.89 OTHER BIPOLAR DISORDER Medical Management 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F41.9 ANXIETY DISORDER, UNSPECIFIED Medical Management 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F22 DELUSIONAL DISORDERS Medical Management 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C H91.93 UNSPECIFIED HEARING LOSS, BILATERAL N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C R13.19 OTHER DYSPHAGIA N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C I70.91 GENERALIZED ATHEROSCLEROSIS Cardiovascular and Coagulations 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C I10 ESSENTIAL (PRIMARY) HYPERTENSION N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C K21.9 GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C G47.00 INSOMNIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C K59.00 CONSTIPATION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F17.201 NICOTINE DEPENDENCE, UNSPECIFIED, IN REMISSION N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C R44.0 AUDITORY HALLUCINATIONS N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C F32.A DEPRESSION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C I73.89 OTHER SPECIFIED PERIPHERAL VASCULAR DISEASES Cardiovascular and Coagulations 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C G89.29 OTHER CHRONIC PAIN pain of left hip joint chronic neuropathic leg pain N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C M62.81 MUSCLE WEAKNESS (GENERALIZED) musculoskeletal disorder N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C R26.89 OTHER ABNORMALITIES OF GAIT AND MOBILITY N/A, not an acceptable Primary Diagnosis 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C This diagnosis is no longer active. G20 PARKINSON'S DISEASE tremors Acute Neurologic 4/24/2023 Diagnosis Rank Insignificant 4/24/2023 update C M25.80 OTHER SPECIFIED JOINT DISORDERS, UNSPECIFIED JOINT

Allergies

Risperidone