Report #2846442

Received Jun 18, 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: 91 yrs
State: IA
Recovered: Not recovered
Vaccinated: Apr 24, 2025
Onset: Jun 17, 2025
Days to onset: 54
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3046731	IM / RA

Symptoms (1)

Death

Symptom narrative

Passed away

Medical history

personality disorder, squamous cell carcinoma of skin of scalp and neck, actinic keratosis, ptsd, strabismic amblyopia, anemia, hypertension,

Other medications

acetaminophen, buspirone, ferrous sulfate, fluticasone, levothyroxine, mirtazapine, omeprazole, sodium chloride, sucralfate, ursodiol, venlafaxine, vitamin c