Report #2852832

Received Aug 5, 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: 64 yrs
State: IA
Recovered: Unknown
Vaccinated: Oct 10, 2024
Onset: Aug 4, 2025
Days to onset: 298
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3043159	IM / LA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

UNSPECIFIED SEQUELAE OF CEREBRAL INFARCTION, PERSONAL HISTORY OF MALIGNANT NEOPLASM OF EYE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CHRONIC VIRAL HEPATITIS C, HEMIPLEGIA AND HEMIPARESIS FOLLOWING CEREBRAL INFARCTION AFFECTING UNSPECIFIED SIDE, HYPOTHYROIDISM,

Other medications

Gabapentin, Furosemide, Mirtazapine, Levothyroxine, Oxybutynin, clog zapper, Xarelto, Senna, Potassium chloride, Zegerid powder, Digoxin, Tramadol, Acetaminophen, Ondansetron, Polyethylene

Allergies

none noted