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Report #2839448

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
76 yrs
State
IA
Recovered
Not recovered
Vaccinated
Nov 19, 2024
Onset
May 3, 2025
Days to onset
165
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNAUNK3043332IM / RA

Symptoms (1)

Death

Symptom narrative

passed away

Medical history

alzeheimers disease, dysthymic disorder, dysphagia, CHF, paroxysmal atrial fibrillation, atherosclerotic heart disease of native coronary artery without angina pectoris, hyperlipidemia, hypertension, type 2 diabetes, bph, vit d deficiency, ptsd, hypomagnesemia, kidney disease, cardiomyopathy

Other medications

aspirin, atorvastatin, docusate sodium, ezetimibe, furosemide, isosrbide, jardiance, loratadine, losartan potassium, meloxicam, memantine, oyster shell calcium, sertraline, tamsulosin, thera-tab multivitamin, acetaminophen, carvedilol, eliq

Allergies

NKA