Report #2844495

Received Jun 10, 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: 93 yrs
State: IA
Recovered: Not recovered
Vaccinated: Jun 27, 2024
Onset: Jun 1, 2025
Days to onset: 339
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	LW230528	IM / LA

Symptoms (1)

Death

Symptom narrative

Passed away

Medical history

Dementia, anemia, kidney disease, dysphagia, epilepsy, glaucoma, insomnia, osteoarthritis, allergic rhinitis, vit d deficiency, anxiety, depression, hypothyroidism, blindness

Other medications

Tylenol, loperamide hcl, cetirizine, docusate sodium, donepezil, furosemide, levetiracetam, levothyroxine sodium, lorazepam, melatonin, metoprolol, morphine sulfate, senna, trazodone

Allergies

NKA