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Report #2856274

Received Sep 1, 2025

HospitalizedOffice visit
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
79 yrs
State
FL
Recovered
Unknown
Vaccinated
Jan 2, 2021
Onset
—
Days to onset
—
Hospital days
1

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1011L20AIM / LA

Symptoms (4)

ArrhythmiaCardiac disorderCardioversionLoss of consciousness

Symptom narrative

Arrythmias, heart issues, passing out, cardioversion

Lab data

cardioversion