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Report #2862550

Received Oct 1, 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
81 yrs
State
IA
Recovered
Unknown
Vaccinated
Sep 10, 2025
Onset
Sep 30, 2025
Days to onset
20
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13046734IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, MALIGNANT NEOPLASM OF PROSTATE, SECONDARY MALIGNANT NEOPLASM OF BONE, IRON DEFICIENCY ANEMIA SECONDARY TO BLOOD LOSS (CHRONIC), HYPERKALEMIA, HYPOTHYROIDISM, CHRONIC KIDNEY DISEASE, STAGE 4 (SEVERE), UNSPECIFIED ATRIAL FIBRILLATION, HYPERLIPIDEMIA, UNSPECIFIED, GASTRO-ESOPHAGEAL REFLUX DISEASE WITH ESOPHAGITIS, WITHOUT BLEEDING, SYSTEMIC LUPUS ERYTHEMATOSUS, UNSPECIFIED,

Other medications

Amlodipine, trazadone, Pravastatin, Levothyroxine, Escitalopram, Triamcinolone cream, Vitamin B-12, Senna, deep sea nasal spray, Carbidopa-Levodopa, Acetaminophen, Gabapentin, Reguloid powder, Metoprolol, tramadol, Sodium Polystyrene Sulf

Allergies

Haloperidol, Peanut-containing drug products, Peanuts, Latex