Report #2858556

Received Sep 13, 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: 76 yrs
State: CA
Recovered: Unknown
Vaccinated: Sep 12, 2025
Onset: Sep 12, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052549	IM / LA

Symptoms (2)

ChillsVomiting

Symptom narrative

patient states that he was given the covid vaccine yesterday morning and overnight he devloped really bad chills, and was vomiting.

Current illness

none listed

Medical history

BPH, GERD, HBP, Gout, Heart

Other medications

Tamsulosin 0.4mg , lansoprazole 30mg, Percoced 5/325 mg, Allopurinol 300mg, lisinopril 10mg, Metoprolol ER 50mg, Amlodipine 5mg, Eliquis 2.5mg

Allergies

none listed

Lab data

none