Report #2852620

Received Aug 4, 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: 61 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 17, 2024
Onset: Aug 1, 2025
Days to onset: 288
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3043332	IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

CHRONIC RESPIRATORY FAILURE WITH HYPOXIA, HYPERTENSIVE HEART DISEASE WITH HEART FAILURE, CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE, SCHIZOAFFECTIVE DISORDER, BIPOLAR TYPE, NICOTINE DEPENDENCE, PANLOBULAR EMPHYSEMA, OBSTRUCTIVE SLEEP APNEA (ADULT) ,MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES

Other medications

Mi- Acid, Albuterol neb, Atorvastatin, Docusate, Ziprasidone, Incruse inhaler, Nicotine lozenge, Fluocinonide solution, Albuterol inhaler, Furosemide, Antifungal powder, Duloxetine, lisinopril, Xarelto, Systane, Triamcinolone, Symbicort, Di

Allergies

Aripiprazole, Haloperidol, Quetiapine, Risperidone, Sertraline, Valproic Acid, Invega, Penicillin's, Bee pollen, Bee stings.