Report #2900291

Received Jun 16, 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: 91 yrs
State: IA
Recovered: Not recovered
Vaccinated: Apr 2, 2026
Onset: Apr 2, 2026
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052786	IM / LA

Symptoms (1)

Death

Symptom narrative

Resident Expired

Current illness

N/A

Medical history

HEART FAILURE, PROTEIN-CALORIE MALNUTRITION, CHRONIC SINUSITIS, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED DEMENTIA, HYPERLIPIDEMIA, ESSENTIAL (PRIMARY) HYPERTENSION,VITAMIN D DEFICIENCY, HYPOTHYROIDISM,CONSTIPATION, DEPRESSION, CHRONIC PAIN, RESTLESS LEGS SYNDROME, POLYNEUROPATHY,EPILEPSY,GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS,AGE-RELATED OSTEOPOROSIS

Other medications

DOK, Jardiance, Levothyroxine, MiraLax, Mirtazapine, Ropinirole, D3, Levetiracetam, Midodrine, Systane Opththalmic, Gabapentin, Tramadol,

Allergies

PCN, Sulfa Antibiotics

Lab data

N/A