Report #2877677

Received Dec 12, 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: 79 yrs
State: GA
Recovered: Not recovered
Vaccinated: Dec 10, 2025
Onset: Dec 11, 2025
Days to onset: 1
Hospital days: —

Vaccines (4)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	UNK	3052733	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	UNK	UT8820CA	IM / LA
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	UNK	MA2488	IM / RA
RSV	RSV (ABRYSVO)	PFIZER\WYETH	UNK	MM9167	IM / LA

Symptoms (1)

Death

Symptom narrative

Immunizations given on 12/10/25 he passed away on 12/11/25

Other medications

Losartan 25mg , Prednisone 10mg , Glyburide 1.25mg , Gabapentin 300mg , Albuterol HFA INH 18GM , Abiraterone 250mg, Furosemide 4mg , Lovastatin 20mg, Tamsulosin 0.4MG , Atorvastatin 80MG , Dorzolamide 2% 10ml , Prednisone 20MG , Brimonidine