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Report #2892602

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
95 yrs
State
MA
Recovered
Not recovered
Vaccinated
Apr 9, 2026
Onset
Apr 11, 2026
Days to onset
2
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA MNEXSPIKE))MODERNAUNK3052030IM / RA

Symptoms (4)

DeathDysphagiaGeneral physical health deteriorationHypophagia

Symptom narrative

04/09/26: received COVID vaccine to RD. 04/10/26: resident at baseline. 04/11/26: resident noted with decline in status; poor po intake, unable to swallow, holding meds in mouth. 04/11/26: continue with decline, end of life signs noted , start roxanol. 04/11/26: resident expired.

Current illness

N/A

Medical history

DEMENTIA, WEAKNESS, REPEATED FALLS, ATHEROSCLEROTIC HEART DISEASE, CHF, HYPERLIPIDEMIA, HYPOTHYRODISM, TYPE 2 DIABETES, VITAMIN D DEFICIENCY, ANEMIA, CROHN'S DISEASE, DYSPHAGIA, OTHER SYMPTOMS AND SIGNS INVOLVING THE MUSCULOKSKELETAL SYSTEM.

Other medications

PRN APAP, ASPIRIN 81MG DAILY, PRN BISACODYL SUPPOSITORY, BUDESONIDE 9MG DAILY, VITAMIN B12 1,000 MCG/ML ONCE MONTHLY, VITAMIN B12 500MCG DAILY, FERROUS SULFATE 325MG DAILY, FUROSEMIDE 20MG DAILY, LEVOTHYROXINE 50MCG DAILY, LEXAPRO 7.5MG DAI

Allergies

ARICEPT, LEVOFLOXACIN, METRONIDAZOLE, ZOCOR.

Lab data

N/A