Report #2859395

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: 77 yrs
State: AR
Recovered: Unknown
Vaccinated: Aug 4, 2021
Onset: Sep 15, 2025
Days to onset: 1503
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	042B21A	IM / LA

Symptoms (1)

COVID-19

Symptom narrative

hospitalized with COVID

Current illness

unknown

Medical history

unknown

Other medications

unknown

Allergies

acetaminophen