Report #2840460

Received May 12, 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: 72 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 17, 2024
Onset: May 11, 2025
Days to onset: 206
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

narcolepsy, obstructive uropathy, gerd, heart failure, copd

Other medications

famotidine, finasteride, sertraline, senexon, tamsulosin, vit d3, amiodarone, amphetamine dextroamphetamine, armodafinil, aspirin, bisacodyl, doxazosin, jardiance, ketoconazole, levothyroxine, potassium chloride, spironolactone, eliquis, e

Allergies

diazepam