Report #2847393

Received Jun 26, 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: 85 yrs
State: IA
Recovered: Not recovered
Vaccinated: Jan 4, 2024
Onset: Jun 25, 2025
Days to onset: 538
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8057413	IM / RA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Current illness

NEUROCOGNITIVE DISORDER WITH LEWY BODIES, ANXIETY DISORDER, UNSPECIFIED, CHRONIC ISCHEMIC HEART DISEASE, UNSPECIFIED, PURE HYPERCHOLESTEROLEMIA, UNSPECIFIED, HYPERLIPIDEMIA, UNSPECIFIED, OTHER OBSTRUCTIVE AND REFLUX UROPATHY, GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS

Other medications

Alprazolam, Omeprazole, Aspirin, Finasteride, Clopidogrel Bisulfate, Atorvastatin, Donepezil,

Allergies

Haloperidol