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Report #2834011

Received Apr 2, 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
71 yrs
State
TN
Recovered
Not recovered
Vaccinated
May 22, 2021
Onset
Jan 2, 2023
Days to onset
590
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA2022B21A—

Symptoms (1)

Breakthrough COVID-19

Symptom narrative

Covid-19 Breakthrough infection

Current illness

Unknown

Medical history

Cirrhosis of the Liver, COPD, CAD, AFib, Esophageal varices

Other medications

MAR not submitted

Allergies

NKA