Report #2850547

Received Jul 21, 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: 84 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 28, 2024
Onset: Jul 18, 2025
Days to onset: 263
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	—	—

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

ALZHEIMER'S DISEASE, PARKINSONISM, EMPHYSEMA, HYPERLIPIDEMIA, HYPERTENSION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS

Other medications

Medications at time of admit date to our facility: Acetaminophen, Finasteride, Metoprolol, Memantine, Amlodipine, Quetiapine

Allergies

NKA