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Report #2892575

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
Female
Age
90 yrs
State
IA
Recovered
Unknown
Vaccinated
Oct 7, 2025
Onset
Apr 12, 2026
Days to onset
187
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA18146367IM / LA

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

CHRONIC SYSTOLIC (CONGESTIVE) HEART FAILURE, DISORDER OF THE SKIN AND SUBCUTANEOUS TISSUE, UNSPECIFIED, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS, CHRONIC KIDNEY DISEASE, STAGE 3B, CHRONIC ATRIAL FIBRILLATION, UNSPECIFIED, VENOUS INSUFFICIENCY (CHRONIC) (PERIPHERAL), NON-PRESSURE CHRONIC ULCER OF UNSPECIFIED PART OF RIGHT LOWER LEG WITH FAT LAYER EXPOSED, NON-PRESSURE CHRONIC ULCER OF UNSPECIFIED PART OF LEFT LOWER LEG WITH FAT LAYER EXPOSED,

Other medications

Glipizide, Colchicine, Fiber-lax, Warfarin, Furosemide, Tramadol, Lidocaine ointment, Potassium Chloride, Famotidine, Systane, Vitamin D3, Gabapentin, Jardiance, Metoprolol, analgesic balm, Miconazole powder, Sertraline, Aspirin, Allopurino

Allergies

Atorvastatin, Dronedarone, NSAIDS, Sulfa Antibiotics