Report #2859176

Received Sep 16, 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: 78 yrs
State: TX
Recovered: Recovered
Vaccinated: Sep 11, 2025
Onset: Sep 12, 2025
Days to onset: 1
Hospital days: —

Vaccines (1)

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

Symptoms (1)

Chills

Symptom narrative

I experienced an extreme session of chills, lasting just over one hour.

Medical history

Polycystic kidney disease, Hypertension, Acid reflux

Other medications

Lansoprazole, Atorvastatin, Losartan/HCTZ, Metoprolol, Cetirizine, Multivitamin, D3, Magnesium, Calcium & Zinc