Report #2896330

Received May 12, 2026

DiedHospitalized

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: 12 yrs
State: CA
Recovered: Not recovered
Vaccinated: Nov 26, 2025
Onset: Feb 18, 2026
Days to onset: 84
Hospital days: 4

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	5	8146545	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	2	UT8779MA	IM / LA

Symptoms (2)

Cardiac arrestDeath

Symptom narrative

Sudden Cardiac arrest and Death

Current illness

Acute sinusitis, migraine,

Other medications

Fluticasone Nasal Suspension

Allergies

Compazine

Lab data

Admission to hospital