VAERS Explorer
Back to explore

Report #2829281

Received Mar 4, 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
83 yrs
State
IA
Recovered
Not recovered
Vaccinated
Oct 7, 2024
Onset
Mar 3, 2025
Days to onset
147
Hospital days
—

Vaccines (1)

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

Symptoms (1)

Death

Symptom narrative

Death

Medical history

J44.9 CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED NTA (2 pts) Pulmonary 1/2/2024 Primary Diagnosis (#67) 1/2/2024 update C E44.0 MODERATE PROTEIN-CALORIE MALNUTRITION NTA (1 pts) Medical Management 7/15/2024 Diagnosis C 10/9/2024 update C I25.10 ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS Cardiovascular and Coagulations 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C N40.0 BENIGN PROSTATIC HYPERPLASIA WITHOUT LOWER URINARY TRACT SYMPTOMS N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C J30.9 ALLERGIC RHINITIS, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C F32.A DEPRESSION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C K21.9 GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C H61.20 IMPACTED CERUMEN, UNSPECIFIED EAR N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C I10 ESSENTIAL (PRIMARY) HYPERTENSION N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C R91.1 SOLITARY PULMONARY NODULE N/A, not an acceptable Primary Diagnosis 1/2/2024 Diagnosis Rank Insignificant 1/2/2024 update C C44.92 SQUAMOUS CELL CARCINOMA OF SKIN, UNSPECIFIED

Allergies

NKA