Report #2841628

Received May 19, 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: 77 yrs
State: IA
Recovered: Not recovered
Vaccinated: Apr 23, 2025
Onset: May 15, 2025
Days to onset: 22
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3046731	IM / LA

Symptoms (1)

Death

Symptom narrative

Passed away

Medical history

obstructive uropathy, gerd, hyperlipidemia, copd, bipolar disorder, orthostatis hypotension, dementia, anemia

Other medications

melatonin, methocarbam, multivitamin, myrbetriq, symbicort, tamsulosin, trospium cl, fludrocort, incruse ellipta, lubriderm lotion, quetiapine furnarate, divalproex, pantoprazole, acetaminophen, tramadol, albuterol, lorazepam

Allergies

aripiprazole, haloperidol