Report #2834012

Received Apr 2, 2025

Hospitalized

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: 88 yrs
State: MN
Recovered: Unknown
Vaccinated: Nov 24, 2023
Onset: Mar 30, 2025
Days to onset: 492
Hospital days: 2

Vaccines (6)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	010M20A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	014M20A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	013F21A	IM / RA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	4	056A22A	IM / RA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	5	GJ5342	IM / LA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	6	HF9300	IM / LA

Symptoms (3)

CoughRespiratory tract congestionViral test

Symptom narrative

Cough, congestion

Current illness

Unknown

Medical history

CHF, hypertension, grovers disease,

Other medications

aricept, nitro, tamsulosin, apixaban, furosemide, amiodarone, isosorbide mononitrate, levothyroxine, simvastatin, omeprazole, potassium chloride, metoprolol,

Allergies

atorvastatin, adhesives

Lab data

IDNOW