Report #2887142

Received Feb 27, 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: 77 yrs
State: IA
Recovered: Unknown
Vaccinated: Oct 15, 2025
Onset: Feb 26, 2026
Days to onset: 134
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052669	IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITH FLUCTUATIONS, TYPE 2 DIABETES MELLITUS WITH DIABETIC POLYNEUROPATHY, CHRONIC LYMPHOCYTIC LEUKEMIA OF B-CELL TYPE NOT HAVING ACHIEVED REMISSION, GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS, MALIGNANT NEOPLASM OF PROSTATE, HYPERLIPIDEMIA

Other medications

Acetaminophen, Analgesic balm, Lantus insulin, Gabapentin, Meloxicam, Trospium, Tamsulosin, Metformin, Lisinopril, Metamucil powder, Pantoprazole, Glimepiride, Finasteride, Jardiance, Duloxetine, Vitamin B-12, Clonidine, Thiamine Mononitrat

Allergies

Haloperidol, rosuvastatin