Report #2877469

Received Dec 11, 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: 72 yrs
State: IA
Recovered: Unknown
Vaccinated: Jan 27, 2022
Onset: Dec 10, 2025
Days to onset: 1413
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	1	FJ5683	IM / RA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE, IRON DEFICIENCY ANEMIA, UNSPECIFIED, PERSONAL HISTORY OF DISEASES OF THE BLOOD AND BLOOD-FORMING ORGANS AND CERTAIN DISORDERS INVOLVING THE IMMUNE MECHANISM, OBSTRUCTIVE AND REFLUX UROPATHY