Report #2856858

Received Sep 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: 77 yrs
State: IA
Recovered: Unknown
Vaccinated: May 22, 2024
Onset: Sep 3, 2025
Days to onset: 469
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	207h23-2A	IM / LA

Symptoms (1)

Death

Symptom narrative

patient passed away

Medical history

SCHIZOAFFECTIVE DISORDER, BIPOLAR TYPE, ESSENTIAL (PRIMARY) HYPERTENSION, ACUTE SYSTOLIC (CONGESTIVE) HEART FAILURE, CHRONIC KIDNEY DISEASE, STAGE 3A, GENERALIZED ANXIETY DISORDER

Other medications

acetaminophen, Metoprolol, Potassium, pantoprazole, cranberry concentrate capsule, atorvastatin, lorazepam, hydralazine, lisinopril, Fludrocort, loratadine, melatonin, Thera-m oral , prazosin, senexon-s, Flunisolide, acidophilous chew

Allergies

NKA