Report #2880784

Received Jan 6, 2026

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: 70 yrs
State: NC
Recovered: Unknown
Vaccinated: Jan 5, 2026
Onset: Jan 5, 2026
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	8146743	IM / LA

Symptoms (1)

Expired product administered

Symptom narrative

Vaccine was thawed by company and sent to Health Center. Reported BUD by company is 01/03/2026. Patient was given vaccine with a BUD of 01/03/2026 on 01/06/2026; No adverse events, treatments, or outcomes to report at this time.

Current illness

N/A

Medical history

-Urolithiasis -Uncontrolled Type 2 Diabetes Mellitus -Stage 3 Chronic Kidney Disease -Osteomyelitis -Hyperlipidemia -Coronary Artery Disease -Complete Amputation of Left Foot -Congestive Heart Failure -Cardiomyopathy -Atrial Fibrillation -Anemia

Other medications

-Amlodipine-olmesartan (AZOR) 5-20 mg per tablet daily -Apixaban (ELIQUIS) 5 mg tab daily -Aspirin 81 mg DR tablet daily -Baclofen 20 mg tablet as needed -Insulin glargine U-300 conc (TOUJEO MAX U-300 SOLOSTAR) 300 unit/mL (3 mL) daily

Allergies

Lisinopril- Cough / Promethazine- Nausea/Vomiting