Report #2902535

Received Jul 6, 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: 93 yrs
State: IA
Recovered: Unknown
Vaccinated: Apr 2, 2026
Onset: Jul 3, 2026
Days to onset: 92
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052786	IM / RA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

INTERSTITIAL PULMONARY DISEASE, UNSPECIFIED, TYPE 2 DIABETES MELLITUS WITH DIABETIC POLYNEUROPATHY, CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE, CHRONIC KIDNEY DISEASE, STAGE 3A, MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED, HYPERLIPIDEMIA, UNSPECIFIED, IRRITABLE BOWEL SYNDROME, UNSPECIFIED

Other medications

urinary pain relief, Lubiprostone, Hydrocodone- Acetaminophen, Oxybutynin, Meloxicam, Famotidine, Tramadol, Diclofenac Sodium, Gabapentin, Anoro Ellipta inhalation, Ipratropium- Albuterol solution, hall cough drops, Escitalopram, Docusate

Allergies

Penicillin