Report #2877474

Received Dec 11, 2025

Hospitalized

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: 69 yrs
State: PA
Recovered: Not recovered
Vaccinated: Dec 3, 2025
Onset: Dec 3, 2025
Days to onset: 0
Hospital days: 4

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3053258	IM / UN

Symptoms (17)

Acute kidney injuryAstheniaBlood creatinine increasedBlood culture negativeBlood lactic acid increasedCatheterisation cardiac abnormalChest X-ray normalComputerised tomogram abdomen normalDistributive shockHaemoglobin decreasedHypotensionIntensive careLactic acidosisRespiratory viral panelUrine analysis normalViral test negativeWhite blood cell count decreased

Symptom narrative

Started feeling generalized weakness on 12/5/25 after 12/3/25 Covid vacination. Presented to Hospital ED on 2/8/25. hypotensive, acute renal failure, lactic acidosis. Started on levophed and admitted to ICU.

Current illness

none

Medical history

CAD sp CABG, CM, +ICD, aortic stenosis, paroxysmal Afib, iron deficiency anemia, OSA, chronic back pain, PAD

Other medications

Eliquis, plavix, cyanocobalmin, farxiga, flonase, lasix, neurontin, atrovent, levothyroxine, linaclotide, metoprolol, protonix, crestor, spironolactone, ultram, traxodone, valsartan

Allergies

clarithromycin, penicillin

Lab data

12/8/25 - blood cultures negative; UA clear; viral respiratory panel neg; cxr clear; abd CT benign; lactic acid 11.7, creatinine 4.03; WBC 4.1, Hgb 7.9 //// 12/10: lactic acid 4.4; right heart catheterization indicated distributive shock