Report #2893242

Received Apr 20, 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: 78 yrs
State: IA
Recovered: Unknown
Vaccinated: Dec 19, 2025
Onset: Apr 18, 2026
Days to onset: 120
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8146751	IM / LA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE, ALZHEIMER'S DISEASE WITH LATE ONSET, LONGSTANDING PERSISTENT ATRIAL FIBRILLATION, PRESENCE OF PROSTHETIC HEART VALVE, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS , NONRHEUMATIC AORTIC (VALVE) STENOSIS, PARKINSON'S DISEASE WITH DYSKINESIA, WITH FLUCTUATIONS, PERMANENT ATRIAL FIBRILLATION,

Other medications

Memantine, Eliquis, Acetaminophen, Amoxicillin, Doxazosin, Digoxin, Atorvastatin, Aspirin, Metoprolol Tartrate

Allergies

Haloperidol