Report #2835988

Received Apr 14, 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: 81 yrs
State: IA
Recovered: Not recovered
Vaccinated: Jan 9, 2025
Onset: Apr 14, 2025
Days to onset: 95
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	6	3044202	IM / RA

Symptoms (1)

Death

Symptom narrative

Passed away

Medical history

vascular dementia, vitreous degeneration of eye, macular degeneration, osteoarthritis, gerd

Other medications

atorvastatin, carbamide peroxide, cetirizine, melatonin, meloxicam, omeprazole, sertraline, therapeutic m multivitamin, tramadol, tums

Allergies

sulfa antibiotics