Report #2868151

Received Oct 24, 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: 89 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 17, 2025
Onset: Oct 24, 2025
Days to onset: 7
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	—	IM / LA

Symptoms (1)

Death

Symptom narrative

Expired on 10/24/2025

Current illness

On hospice care

Medical history

GENERALIZED ANXIETY DISORDER,ESSENTIAL (PRIMARY) HYPERTENSION,GOUT,HALLUCINATIONS,DELUSIONAL DISORDERS,UNSPECIFIED PSYCHOSIS NOT DUE TO A SUBSTANCE OR KNOWN PHYSIOLOGICAL CONDITION,BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS,TYPE 2 DIABETES MELLITUS ,ALZHEIMER'S DISEASE

Other medications

Cetirizine HCL, Doxazosin Mesylate, Lasix, Melatonin, Olanzapine, Omeprazole, Polyethylene Glycol, Sertraline, Trazodone, Docusate Sodium, Senna, Tylenol, Gabapentin, Simethicone,

Allergies

Codeine, Donepezil, Galantamine