Report #2902767

Received Jul 7, 2026

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: 72 yrs
State: FL
Recovered: Unknown
Vaccinated: Nov 2, 2021
Onset: Jul 4, 2026
Days to onset: 1705
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	040A21A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	032B21A	IM / LA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	058F21A	IM / RA

Symptoms (2)

COVID-19SARS-CoV-2 test positive

Symptom narrative

Patient was vaccinated for and then tested positive for COVID-19virus.