Report #2859388

Received Sep 17, 2025

Hospitalized

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: 83 yrs
State: AR
Recovered: Unknown
Vaccinated: Sep 4, 2024
Onset: Sep 7, 2025
Days to onset: 368
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	6	3042388	IM / RA

Symptoms (1)

COVID-19

Symptom narrative

hospitalized with COVID

Current illness

unknown

Medical history

afib, BPH

Other medications

unknown

Allergies

NKDA