Report #2870494

Received Nov 4, 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: Female
Age: 83 yrs
State: PA
Recovered: Recovered
Vaccinated: Oct 31, 2025
Onset: Oct 1, 2025
Days to onset: —
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	UNK	3052082	IM / RA

Symptoms (1)

Refusal of vaccination

Symptom narrative

Resident consent was only for flu vaccine given Covid vaccine in addition to influenza in error.

Current illness

Dementia, stage 1 ckd, , hx uti, hypothyroidism,

Medical history

Osteoporosis , overactive bladder, hyperlipidema, mood disturbance, anxiety disorder

Other medications

Atorvastatin, Azelastine 0.1 %, buspirione HCL , donepezil, dulcolax, gemtesa, ibandronate sodium, levothyroxine, lisinopril, loratadine, methenamine, senna, Tylenol as needed

Allergies

Doxycycline, sulfa