Report #2860763

Received Sep 23, 2025

DiedER / ED visit

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: 56 yrs
State: NM
Recovered: Not recovered
Vaccinated: Sep 13, 2025
Onset: Sep 21, 2025
Days to onset: 8
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	7+	3051995	IM / RA
VARZOS	ZOSTER (SHINGRIX)	GLAXOSMITHKLINE BIOLOGICALS	2	NR4TS	IM / LA

Symptoms (1)

Death

Symptom narrative

Patient passed away 9/21/25 at the hospital.

Medical history

hypertension, diabetes

Other medications

lisinopril 10mg, Mounjaro 5mg, Synjardy XR 12.5mg/1000mg,

Allergies

none