Report #2826852

Received Feb 18, 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: 83 yrs
State: MN
Recovered: Not recovered
Vaccinated: Nov 11, 2024
Onset: Feb 15, 2025
Days to onset: 96
Hospital days: —

Vaccines (6)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	013A21A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	082A21A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	051F21A	IM / LA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	4	FP7140	IM / LA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	5	HG6396	IM / LA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	6	LN0589	IM / LA

Symptoms (1)

Death

Symptom narrative

Patient expired on 2/15/2025.

Current illness

Unknown

Medical history

Hypertension, hyperlipidemia, peripheral artery disease, tobacco use disorder, sensorineural hearing loss, metastatic uveal melanoma

Other medications

Unknown

Allergies

No known allergies

Lab data

N/A