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Report #2855188

Received Aug 22, 2025

HospitalizedER / ED visitDisabled
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
62 yrs
State
AZ
Recovered
Unknown
Vaccinated
Nov 6, 2024
Onset
Dec 16, 2024
Days to onset
40
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLUBLOK)SANOFI PASTEUR1U8440AAIM / RA

Symptoms (1)

Myocarditis

Symptom narrative

myocarditis

Current illness

na

Medical history

? Cataract ? Open angle with borderline findings ? Bradycardia ? Hyperlipidemia ? Controlled type 2 diabetes mellitus without complication (HCC) ? Benign prostatic hyperplasia without lower urinary tract symptoms ? Bilateral impacted cerumen ? Word finding difficulty ? Type 2 diabetes mellitus with both eyes affected by mild nonproliferative retinopathy without macular edema, without long-term current use of insulin (HCC) ? Abnormal thyroid function test

Other medications

? metFORMIN (GLUCOPHAGE) 500 mg oral tablet TAKE 2 TABLETS BY MOUTH TWO TIMES A DAY ? atorvastatin (LIPITOR) 40 mg oral tablet Take 1 tablet by mouth daily ? blood glucose test strip (CONTOUR NEXT TEST STRIPS) 1 strip by miscellaneous route

Allergies

glipizide