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Report #2866645

Received Oct 17, 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
88 yrs
State
KY
Recovered
Not recovered
Vaccinated
Oct 10, 2025
Onset
Oct 16, 2025
Days to onset
6
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (PFIZER-BIONTECH))PFIZER\BIONTECH7+MY9547IM / LA
FLU3INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR1u8855caIM / LA

Symptoms (1)

Death

Symptom narrative

Expired 10/16/25

Current illness

SPASTIC HEMIPLEGIA AFFECTING RIGHT DOMINANT SIDE SLP Acute Neurologic 1/23/2022 Primary/Principal/Admission (67) Primary/Principal/Admission 2/18/2025 update G40.919 EPILEPSY, UNSPECIFIED, INTRACTABLE, WITHOUT STATUS EPILEPTICUS please disregard dx code F44.5, entered in error NTA (1 pts) Medical Management 10/20/2022 Secondary #1 During Stay 10/20/2022 update G30.9 ALZHEIMER'S DISEASE, UNSPECIFIED Medical Management 12/13/2019 Secondary #2 Admitting Dx (69) 12/13/2019 update F02.818 DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE N/A, not an acceptable Primary Diagnosis 10/1/2022 Secondary #3 Admitting Dx (69) 10/4/2022 update K90.0 CELIAC DISEASE Medical Management 12/13/2019 Secondary #4 Admitting Dx (69) 12/13/2019 update K22.719 BARRETT'S ESOPHAGUS WITH DYSPLASIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary #5 Admitting Dx (69) 12/13/2019 update M62.81 T MUSCLE WEAKNESS (GENERALIZED) N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #6 During Stay 10/3/2024 update R27.9 T UNSPECIFIED LACK OF COORDINATION N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #7 During Stay 10/3/2024 update Z74.1 T NEED FOR ASSISTANCE WITH PERSONAL CARE N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #8 During Stay 10/3/2024 update R13.12 T DYSPHAGIA, OROPHARYNGEAL PHASE N/A, not an acceptable Primary Diagnosis 9/10/2025 Secondary 9 Or More During Stay 9/11/2025 update R53.1 T WEAKNESS N/A, not an acceptable Primary Diagnosis 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.541 T CONTRACTURE, RIGHT HAND Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.542 T CONTRACTURE, LEFT HAND Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.521 T CONTRACTURE, RIGHT ELBOW Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.522 T CONTRACTURE, LEFT ELBOW Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.512 T CONTRACTURE, LEFT SHOULDER Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.531 T CONTRACTURE, RIGHT WRIST Non-Surgical Orthopedic/Musculoskeletal 1/23/2025 Secondary 9 Or More During Stay 2/11/2025 update Z99.3 T DEPENDENCE ON WHEELCHAIR N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary 9 Or More During Stay 10/3/2024 update D50.9 IRON DEFICIENCY ANEMIA, UNSPECIFIED Medical Management 7/23/2024 Secondary 9 Or More During Stay 10/3/2024 update R13.10 T DYSPHAGIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 2/8/2024 Secondary 9 Or More During Stay 3/7/2024 update Z85.46 PERSONAL HISTORY OF MALIGNANT NEOPLASM OF PROSTATE N/A, not an acceptable Primary Diagnosis 11/17/2023 Secondary 9 Or More During Stay 11/17/2023 update Z96.641 PRESENCE OF RIGHT ARTIFICIAL HIP JOINT N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More During Stay 1/25/2022 update E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 1/23/2022 Secondary 9 Or More Admitting Dx (69) 10/3/2024 update R54 AGE-RELATED PHYSICAL DEBILITY N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More Admitting Dx (69) 10/3/2024 update M24.532 T CONTRACTURE, LEFT WRIST Non-Surgical Orthopedic/Musculoskeletal 1/23/2022 Secondary 9 Or More During Stay 2/11/2025 update G81.10 SPASTIC HEMIPLEGIA AFFECTING UNSPECIFIED SIDE SLP N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More 4/22/2025 update Z86.73 PERSONAL HISTORY OF TRANSIENT ISCHEMIC ATTACK (TIA), AND CEREBRAL INFARCTION WITHOUT RESIDUAL DEFICITS N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More Admitting Dx (69) 9/26/2025 update Z86.16 PERSONAL HISTORY OF COVID-19 N/A, not an acceptable Primary Diagnosis 4/1/2021 Secondary 9 Or More During Stay 6/10/2021 update E03.9 HYPOTHYROIDISM, UNSPECIFIED Medical Management 12/13/2019 Secondary 9 Or More Admitting Dx (69) 12/13/2019 update K59.00 CONSTIPATION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary 9 Or More Admitting Dx (69) 11/30/2020 update I10 ESSENTIAL (PRIMARY) HYPERTENSION N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary 9 Or More Admitting Dx (69) 12/13/2019

Medical history

SPASTIC HEMIPLEGIA AFFECTING RIGHT DOMINANT SIDE SLP Acute Neurologic 1/23/2022 Primary/Principal/Admission (67) Primary/Principal/Admission 2/18/2025 update G40.919 EPILEPSY, UNSPECIFIED, INTRACTABLE, WITHOUT STATUS EPILEPTICUS please disregard dx code F44.5, entered in error NTA (1 pts) Medical Management 10/20/2022 Secondary #1 During Stay 10/20/2022 update G30.9 ALZHEIMER'S DISEASE, UNSPECIFIED Medical Management 12/13/2019 Secondary #2 Admitting Dx (69) 12/13/2019 update F02.818 DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE N/A, not an acceptable Primary Diagnosis 10/1/2022 Secondary #3 Admitting Dx (69) 10/4/2022 update K90.0 CELIAC DISEASE Medical Management 12/13/2019 Secondary #4 Admitting Dx (69) 12/13/2019 update K22.719 BARRETT'S ESOPHAGUS WITH DYSPLASIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary #5 Admitting Dx (69) 12/13/2019 update M62.81 T MUSCLE WEAKNESS (GENERALIZED) N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #6 During Stay 10/3/2024 update R27.9 T UNSPECIFIED LACK OF COORDINATION N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #7 During Stay 10/3/2024 update Z74.1 T NEED FOR ASSISTANCE WITH PERSONAL CARE N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary #8 During Stay 10/3/2024 update R13.12 T DYSPHAGIA, OROPHARYNGEAL PHASE N/A, not an acceptable Primary Diagnosis 9/10/2025 Secondary 9 Or More During Stay 9/11/2025 update R53.1 T WEAKNESS N/A, not an acceptable Primary Diagnosis 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.541 T CONTRACTURE, RIGHT HAND Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.542 T CONTRACTURE, LEFT HAND Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.521 T CONTRACTURE, RIGHT ELBOW Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.522 T CONTRACTURE, LEFT ELBOW Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.512 T CONTRACTURE, LEFT SHOULDER Non-Surgical Orthopedic/Musculoskeletal 4/3/2025 Secondary 9 Or More During Stay 4/9/2025 update M24.531 T CONTRACTURE, RIGHT WRIST Non-Surgical Orthopedic/Musculoskeletal 1/23/2025 Secondary 9 Or More During Stay 2/11/2025 update Z99.3 T DEPENDENCE ON WHEELCHAIR N/A, not an acceptable Primary Diagnosis 7/23/2024 Secondary 9 Or More During Stay 10/3/2024 update D50.9 IRON DEFICIENCY ANEMIA, UNSPECIFIED Medical Management 7/23/2024 Secondary 9 Or More During Stay 10/3/2024 update R13.10 T DYSPHAGIA, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 2/8/2024 Secondary 9 Or More During Stay 3/7/2024 update Z85.46 PERSONAL HISTORY OF MALIGNANT NEOPLASM OF PROSTATE N/A, not an acceptable Primary Diagnosis 11/17/2023 Secondary 9 Or More During Stay 11/17/2023 update Z96.641 PRESENCE OF RIGHT ARTIFICIAL HIP JOINT N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More During Stay 1/25/2022 update E78.5 HYPERLIPIDEMIA, UNSPECIFIED Medical Management 1/23/2022 Secondary 9 Or More Admitting Dx (69) 10/3/2024 update R54 AGE-RELATED PHYSICAL DEBILITY N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More Admitting Dx (69) 10/3/2024 update M24.532 T CONTRACTURE, LEFT WRIST Non-Surgical Orthopedic/Musculoskeletal 1/23/2022 Secondary 9 Or More During Stay 2/11/2025 update G81.10 SPASTIC HEMIPLEGIA AFFECTING UNSPECIFIED SIDE SLP N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More 4/22/2025 update Z86.73 PERSONAL HISTORY OF TRANSIENT ISCHEMIC ATTACK (TIA), AND CEREBRAL INFARCTION WITHOUT RESIDUAL DEFICITS N/A, not an acceptable Primary Diagnosis 1/23/2022 Secondary 9 Or More Admitting Dx (69) 9/26/2025 update Z86.16 PERSONAL HISTORY OF COVID-19 N/A, not an acceptable Primary Diagnosis 4/1/2021 Secondary 9 Or More During Stay 6/10/2021 update E03.9 HYPOTHYROIDISM, UNSPECIFIED Medical Management 12/13/2019 Secondary 9 Or More Admitting Dx (69) 12/13/2019 update K59.00 CONSTIPATION, UNSPECIFIED N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary 9 Or More Admitting Dx (69) 11/30/2020 update I10 ESSENTIAL (PRIMARY) HYPERTENSION N/A, not an acceptable Primary Diagnosis 12/13/2019 Secondary 9 Or More Admitting Dx (69) 12/13/2019

Other medications

ASPIRIN 81, omeprazole, Atorvastatin, Ferrous Sulfate, Keppra 500mg, Synthroid , loperamide, Fluticasone Propionate Suspension 50 MCG/ACT

Allergies

Gluten

Lab data

none