Report #2835681

Received Apr 10, 2025

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: 59 yrs
State: OR
Recovered: Unknown
Vaccinated: Mar 27, 2025
Onset: Mar 27, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	4	B0005	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	N/A	391417	IM / LA

Symptoms (2)

No adverse eventProduct storage error

Symptom narrative

No adverse event reported. Reporting this VAERS per Moderna after a temperature excursion, vaccine remained viable after the excursion per Moderna.

Current illness

None reported

Medical history

postconcussion syndrome, mixed irritable bowel syndrome, restlessness and agitation, cannabis use disorder, nightmares, umbilical hernia, poor short term memory, vitamin d deficiency, pure hypercholesterolemia, history of colonic polyps

Other medications

hydroxyzine HCL, ibuprofen, dicyclomine, atorvastatin

Allergies

No known allergies

Lab data

N/A