Report #2867304

Received Oct 20, 2025

DiedHospitalizedER / ED visitOffice visit

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: 74 yrs
State: IL
Recovered: Not recovered
Vaccinated: Jan 22, 2021
Onset: May 1, 2024
Days to onset: 1195
Hospital days: —

Vaccines (6)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	030L20A	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	011M20A	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	067F21A	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	4	037A22B	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	5	030G22B	SYR / AR
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	6	3031417	SYR / AR

Symptoms (2)

DeathGlioblastoma

Symptom narrative

Patient was pressured, coerced, and fooled into taking six Government funded (through withheld name) Moderna C-19 ModRNA bioweapon shots from Jan 2021 to Dec 2023. Patient was diagnosed with a sudden and aggressive turbo cancer - Grade 4 Glioblastoma on May 22, 2024 and died Oct 21, 2024. (5 months). The bioweapon shots caused or greatly contributed to his sudden death.

Current illness

N/A

Medical history

None

Other medications

N/A

Allergies

N/A