Report #2878139

Received Dec 16, 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: 78 yrs
State: IA
Recovered: Not recovered
Vaccinated: Mar 14, 2025
Onset: Dec 15, 2025
Days to onset: 276
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	—	UN
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	UNK	—	UN

Symptoms (1)

Death

Symptom narrative

Expired

Current illness

Unknown- due to vaccine given prior to admission to facility

Medical history

UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE,PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, TYPE 2 DIABETES MELLITUS WITH DIABETIC POLYNEUROPATHY,CARDIOMYOPATHY,HEART FAILURE,CHRONIC OBSTRUCTIVE PULMONARY DISEASE, VITAMIN D DEFICIENCY, GASTRO-ESOPHAGEAL REFLUX DISEASE WITH ESOPHAGITIS, WITHOUT BLEEDING,