Report #2860548

Received Sep 22, 2025

Died

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: IA
Recovered: Unknown
Vaccinated: Apr 10, 2025
Onset: Sep 21, 2025
Days to onset: 164
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3046731	IM / LA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, UNSPECIFIED DEMENTIA, SEVERE, WITH PSYCHOTIC DISTURBANCE, GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS, ORTHOSTATIC HYPOTENSION, APHASIA,

Other medications

Quetiapine, Ketotif fum eye drops, acetaminophen, carbidopa/levodopa, Senexon-s, Vitamin D3, Ketoconazole cream, polyethylene powder, mirtazapine, Venlafaxine, omeprazole, Amoxicillin as needed for dental appointments, Milk of magnesia,

Allergies

Donepezil, Haloperidol, Lorazepam, Mirabegron, Trospium, Celexa, Lexapro, Zoloft, Sulfa Antibiotics,