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Report #2863410

Received Oct 6, 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
80 yrs
State
IA
Recovered
Unknown
Vaccinated
Oct 25, 2024
Onset
Oct 5, 2025
Days to onset
345
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13042648IM / RA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS, VESICOINTESTINAL FISTULA, ACUTE CYSTITIS WITH HEMATURIA, HYPERLIPIDEMIA, OTHER CRANIAL CEREBROSPINAL FLUID LEAK, HYPOTHYROIDISM,HYPOMAGNESEMIA, IRON DEFICIENCY ANEMIA,

Other medications

Resident received his Covid vaccine before admit. The following medications are the ones this resident admitted with. Fludrocortisone, Senna, Finasteride, Duloxetine, Atorvastatin, Multiple Vitamins with minerals, Magnesium Oxide, Iron, A

Allergies

Chocolate