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Report #2859521

Received Sep 17, 2025

DiedLife-threateningHospitalizedER / ED visitOffice visitDisabled
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
39 yrs
State
TX
Recovered
Not recovered
Vaccinated
Aug 20, 2021
Onset
Sep 17, 2021
Days to onset
28
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1153E21AIM / RA
COVID19COVID19 (COVID19 (MODERNA))MODERNA2051E21AIM / RA

Symptoms (17)

Autonomic nervous system imbalanceBiopsyBlindnessBlisterBlood testCorneal transplantDeathDehydrationDiagnostic procedureDiarrhoeaLaboratory testNecrotising fasciitisPostural orthostatic tachycardia syndromeRenal impairmentSkin lesionVision blurredWeight decreased

Symptom narrative

After COVID vaccination 8/20/21 and 9/10/2021 patient's vision became extremely blurry resulting in eventual legal blindness in both eyes cornea transplant etc; Chronic diarrhea resulting in extreme weight loss, from 250 down to 122 lbs, dehydration, kidney malfunction; Blistering lesions over abdomen lower extremities and hands Patient was in the hospital for 7 months with dysautonomia POTS necrotizing fasciitis Patient expired 04/29/2025 at home after being discharged from long term acute care hosp Hundreds of blood tests Numerous biopsies and diagnostic testing starting Oct 2021 Please see attached information

Current illness

DM 2

Medical history

NONE

Other medications

NONE

Allergies

SHELLFISH

Lab data

NUMEROUS lab tests, diagnostic tests, biopsies etx