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Report #2848646

Received Jul 7, 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
90 yrs
State
IA
Recovered
Not recovered
Vaccinated
Apr 3, 2025
Onset
Jul 5, 2025
Days to onset
93
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13043838IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY, INSOMNIA, GENERALIZED ANXIETY DISORDER, BRADYCARDIA, OTHER SPONDYLOSIS WITH MYELOPATHY, CERVICAL REGION, HYPERLIPIDEMIA,

Other medications

Milk of Magnesia, Acetaminophen, Bisacodyl Suppository, Polyethylene Powder, Tramadol, Lorazepam