Report #2896363

Received May 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: 73 yrs
State: IA
Recovered: Unknown
Vaccinated: Oct 26, 2021
Onset: May 12, 2026
Days to onset: 1659
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	3	FF8841	IM / LA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY, LOCALIZATION-RELATED (FOCAL) (PARTIAL) SYMPTOMATIC EPILEPSY AND EPILEPTIC SYNDROMES WITH COMPLEX PARTIAL SEIZURES, NOT INTRACTABLE, WITHOUT STATUS EPILEPTICUS, DISORDER OF THE AUTONOMIC NERVOUS SYSTEM, UNSPECIFIED, HYPERLIPIDEMIA, UNSPECIFIED, LIVER DISEASE, UNSPECIFIED, TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS

Other medications

Res admitted on 1/16/2024 the following medications were scheduled with admit: Carbidopa- levodopa, Haloperidol, Atorvastatin, Hydroxyzine, Divalproex sodium, Acetaminophen, Polyethylene Powder,

Allergies

Clonazepam, Diazepam, Lorazepam, Quetiapine