VAERS Explorer
Back to explore

Report #2887653

Received Mar 4, 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
64 yrs
State
IA
Recovered
Not recovered
Vaccinated
Oct 28, 2025
Onset
Mar 3, 2026
Days to onset
126
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1—IM / RA

Symptoms (1)

Death

Symptom narrative

resident expired

Current illness

N/A

Medical history

END STAGE RENAL DISEASE, DUODENAL ULCER, UNSPECIFIED AS ACUTE OR CHRONIC, WITHOUT HEMORRHAGE OR PERFORATION,ANEMIA IN OTHER CHRONIC DISEASES CLASSIFIED ELSEWHERE,GASTROINTESTINAL HEMORRHAGE, CHRONIC VASCULAR DISORDERS OF INTESTINE, CELIAC ARTERY COMPRESSION SYNDROME, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS,INSOMNIA,CHRONIC KIDNEY DISEASE, OBSTRUCTIVE SLEEP APNEA, HYPOKALEMIA, HYPOTENSION, DEPENDENCE ON RENAL DIALYSIS,

Other medications

aspirin, atorvastatin, clopidogrel, lidocaine-prilocaine patch, miralax, pantoprazole, rena-vite, senexon-s, trazadone, vitamin B-12, torsemide, calcium acetate, midodrine hcl, sevelamer, acetaminophen,

Allergies

seafood

Lab data

N/A