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Report #2892535

Received Apr 13, 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
70 yrs
State
IA
Recovered
Unknown
Vaccinated
Oct 28, 2025
Onset
Apr 12, 2026
Days to onset
166
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13052669IM / RA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

HEREDITARY SPASTIC PARAPLEGIA, TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS, UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY, EPILEPSY, UNSPECIFIED, NOT INTRACTABLE, WITHOUT STATUS EPILEPTICUS, NEURALGIA AND NEURITIS, UNSPECIFIED, VENOUS INSUFFICIENCY (CHRONIC) (PERIPHERAL), SPINAL STENOSIS, LUMBAR REGION WITHOUT NEUROGENIC CLAUDICATION

Other medications

Diclofenac sodium gel, Morphine, Lorazepam, Duloxetine, Levetiracetam, Pregabalin, Sennosides- Docusate sodium, Bacitracin ointment, refresh eye drops, Tums, Milk of Magnesia , Ondansetron, Sodium chloride irrigation solution,

Allergies

Hydroxypropyl, Methylcellulose