Report #2886980

Received Feb 26, 2026

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: Unknown
Vaccinated: Nov 4, 2025
Onset: Feb 25, 2026
Days to onset: 113
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8146751	IM / RA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED, CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE, CHRONIC RESPIRATORY FAILURE WITH HYPOXIA, TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS, HYPERLIPIDEMIA, AGE-RELATED OSTEOPOROSIS WITH CURRENT PATHOLOGICAL FRACTURE, UNSPECIFIED SITE, INITIAL ENCOUNTER FOR FRACTURE,

Other medications

Melatonin, Hydrocodone-Acetaminophen, Triamcinolone cream, Tizanidine, Antacid suspension, Stiolto Inhaler, Senna, PreserVision Areds, Prednisolone eye drops, Penicillin, Oyster shell calcium, Metoprolol Succinate ER, Jardiance, Furosemide,

Allergies

Florinef, Bee venom