Report #2879701

Received Dec 26, 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: 82 yrs
State: IA
Recovered: Not recovered
Vaccinated: Oct 17, 2025
Onset: Dec 25, 2025
Days to onset: 69
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	8146367	IM / LA

Symptoms (1)

Death

Symptom narrative

Expired

Current illness

UTI

Medical history

UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY, TYPE 2 DIABETES MELLITUS,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,POST-TRAUMATIC STRESS DISORDER, ESSENTIAL (PRIMARY) HYPERTENSION, CHRONIC KIDNEY DISEASE,BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS,LIVER DISEASE,VITAMIN D DEFICIENCY,OBSTRUCTIVE SLEEP APNEA (ADULT),CHRONIC VIRAL HEPATITIS C,ALCOHOL ABUSE,OBSTRUCTIVE AND REFLUX UROPATHY, UNSPECIFIED, MAJOR DEPRESSIVE DISORDER, BIPOLAR DISORDER, IRON DEFICIENCY ANEMIA

Other medications

amlodipine, aripiprazole, finasteride, melatonin. metformin. mirtazapine, omeprazole, prazosin, spiriva, docusate sodium, symbicort, venlafaxine, cephalexine,

Allergies

NKA