Report #2863463

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: 66 yrs
State: IN
Recovered: Not recovered
Vaccinated: Sep 17, 2025
Onset: Sep 17, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3052296	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	UNK	U8837AA	IM / LA

Symptoms (1)

Death

Symptom narrative

NP, ALERTED THE PHARMACY ON 10/6/25 THAT THE PATIENT PASSED AWAY 09/17/2025, THE SAME DAY HE RECEIVED THE TWO VACCINATIONS INDICATED. SHE DOES NOT BELIEVE HIS DEATH IS RELATED TO THE VACCINATIONS BUT WANTED THE PHARMACY TO KNOW, AND WE ARE REPORTING THIS OUT OF AN ABUNDANCE OF PRECATION.