Report #2878197

Received Dec 16, 2025

Life-threateningHospitalizedER / ED visitOffice visitDisabled

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: 71 yrs
State: OK
Recovered: Not recovered
Vaccinated: Feb 1, 2021
Onset: Feb 1, 2021
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	1	—	SYR

Symptoms (4)

Arterial occlusive diseaseChest painFallThrombosis

Symptom narrative

I was walking in the yard and went down. Started Chest pains, called an ambulance. There was a blood clot . It was immediate- sudden

Current illness

Back operation, on a lumbar disc December 29, 2020 --2 days before hospitalization with covid.

Medical history

Diagnosed with copd

Other medications

Ibuprofen, zinc, medicine from covid hospitalization [name withheld] hospital. Vit d, c

Allergies

Codeine, Teflon pearls

Lab data

Blood clot that disappeared and blockages started showing up through out my arteries.