Report #2857368

Received Sep 8, 2025

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: 73 yrs
State: AZ
Recovered: Recovered
Vaccinated: Sep 7, 2025
Onset: Sep 7, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3051995	IM

Symptoms (3)

CoughDyspnoeaRespiratory distress

Symptom narrative

AFTER ADMINISTRATION PATIENT STOOD UP STARTED WITH RESPIRATORY DISTRESS. RR 88 THEN INCREASED TO 111 AFTER 15 MINS. PATIENT HAD DIFFICULTY BREATHING AND CONTINUOUSLY COUGHING. AIR WAY WAS SWOLLEN. EPIPEN 0.3 WAS ADMNISTERED THEN EMS ARRIVED 5 MINS LATER. PATIENT DID NOT IMPROVE UNTIL HOURS LATER AT THE HOSPITAL. PER PATIENT WAS GIVEN MORE EPINEPHRINE, STEROID, ANTIBIOTICS, AND NEBULIZING TREATMENT

Current illness

pneumonia

Medical history

asthma, diabetes, copd

Other medications

famotidine, hydralazine, captopril, advair diskus

Allergies

iodine

Lab data

Prior vaccinations

MODERNA VACCINE 2024