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Report #2854530

Received Aug 18, 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
Female
Age
86 yrs
State
IA
Recovered
Not recovered
Vaccinated
Apr 11, 2025
Onset
Aug 16, 2025
Days to onset
127
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA23046731IM / RA

Symptoms (1)

Death

Symptom narrative

Expired

Medical history

CHRONIC RESPIRATORY FAILURE, UNSPECIFIED WHETHER WITH HYPOXIA OR HYPERCAPNIA, MILD PROTEIN-CALORIE MALNUTRITION, MILD NEUROCOGNITIVE DISORDER DUE TO KNOWN PHYSIOLOGICAL CONDITION WITHOUT BEHAVIORAL DISTURBANCE, OTHER SPECIFIED CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS, ESSENTIAL (PRIMARY) HYPERTENSION, SUPRAVENTRICULAR TACHYCARDIA, UNSPECIFIED, TYPE 2 DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATION, MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED, GENERALIZED ANXIETY DISORDER, PERSONAL HISTORY OF MALIGNANT NEOPLASM OF UNSPECIFIED SITE OF LIP, ORAL CAVITY, AND PHARYNX

Other medications

Aspirin, Atorvastatin, Diltiazem, Fluticasone Propionate, Incruse Ellipta, Lidocaine, Melatonin, Mirtazapine, Pramipexole Dihydrochloride, Senna, sodium fluoride, Tamsulosin HCL, Multivitamin with minerals, Vitamin D3, Advair Diskus, Chlor

Allergies

Clonazepam, Mepivacaine, Midazolam