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Report #2876825

Received Dec 9, 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
68 yrs
State
IA
Recovered
Not recovered
Vaccinated
Oct 7, 2025
Onset
Dec 8, 2025
Days to onset
62
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA18146367IM / LA
COVID19COVID19 (COVID19 (MODERNA MNEXSPIKE))MODERNA18146367IM / LA

Symptoms (1)

Death

Symptom narrative

Expired

Medical history

CHRONIC SYSTOLIC (CONGESTIVE) HEART FAILURE, HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE,OBESITY, CLASS 3, ENCOUNTER FOR PALLIATIVE CARE, PULMONARY HYPERTENSION,OBSTRUCTIVE AND REFLUX UROPATHY INSOMNIA,CALCULUS OF KIDNEY,LYMPHEDEMA, OSTEOARTHRITIS,NUTRITIONAL ANEMIA, CHRONIC PAIN, BENIGN PROSTATIC HYPERPLASIA WITHOUT LOWER URINARY TRACT SYMPTOMS, CHRONIC ATRIAL FIBRILLATION, VENOUS INSUFFICIENCY (CHRONIC) (PERIPHERAL), LUMBAGO WITH SCIATICA, LEFT SIDE

Other medications

Loratadine, Cyclobenzaprine HCL ,Docusate Sodium, Lorazepam, Melatonin, Metolazone, Morphine Sulfate, Polyethylene Glycol, Prednisone, Sertraline HCL, Warfarin Sodium, Bumetanide, Cefadroxil, tums, Potassium Chloride,

Allergies

KNA