Report #2839446

Received May 5, 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: 63 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 10, 2024
Onset: May 5, 2025
Days to onset: 207
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3043159	IM / LA

Symptoms (1)

Death

Symptom narrative

passed away

Medical history

schizoaffective disorder, pain, gout, drug induced movement disorder, type 2 diabetes, bph, copd, paroxysmal atrial fibrillation, hyperlipidemia, gerd

Other medications

Fluphenazine; Allopurinol; Atorvastatin; Benztropine; Bupropion; Finasteride; MiraLAX; Stiolto; Trazadone; Venlafaxine; Docusate sodium; Famotidine, ipratropium albuterol, metformin, preservision, propranolol, acetaminphen

Allergies

depakote, intravasular contrast media