Report #2848210

Received Jul 2, 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: 75 yrs
State: IA
Recovered: Not recovered
Vaccinated: Apr 24, 2025
Onset: Jul 2, 2025
Days to onset: 69
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3046731	IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Current illness

UNSPECIFIED CONVULSIONS , ESSENTIAL (PRIMARY) HYPERTENSION, ADJUSTMENT DISORDER WITH DEPRESSED MOOD, HYPERLIPIDEMIA, GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS, COAGULATION DEFECT, PAROXYSMAL ATRIAL FIBRILLATION, HYPOTHYROIDISM,

Other medications

Tramadol, Valproic acid solution, Xarelto, Metoclopram, sertraline, acetaminophen, Senna, Vitamin D3, Finasteride, Atorvastatin, Lidocaine patch, Melatonin, pantoprazole, Lisinopril.

Allergies

Melatonin, Aggrenox, Penicillins, Sulfa Antibotics.