Report #2866222

Received Oct 15, 2025

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: 64 yrs
State: MI
Recovered: Recovered
Vaccinated: Jan 14, 2025
Onset: Oct 14, 2025
Days to onset: 273
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	1	3052735	LA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	UNK	U8859CA	IM / LA

Symptoms (2)

Incorrect dose administeredNo adverse event

Symptom narrative

No Patient adverse event reported. VAERS report is being completed because the patient was not 65 at time of vaccination with Fluzone High Dose (64yr)

Current illness

None reported at time of vaccination

Medical history

hypothyroidism, hyperlipidemia, anxiety, Afib, Aortic Aneurysm w/o rupture, Sequelae of cerebral infarction, hypertension, peripheral vascular disease

Other medications

Unknown

Allergies

NKA

Lab data

None