NSTEMI; Septic shock; Hypoxic respiratory; Hyperkalemic; Bilateral pneumonia; Acute renal failure; Shortness of breath; Fever; Myalgia; Fatigue; Poor PO intake following the vaccine; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of ACUTE MYOCARDIAL INFARCTION (NSTEMI), SEPTIC SHOCK (Septic shock), RESPIRATORY FAILURE (Hypoxic respiratory), HYPERKALAEMIA (Hyperkalemic), PNEUMONIA (Bilateral pneumonia) and ACUTE KIDNEY INJURY (Acute renal failure) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     the concomitant product the patient had taken are Norvasc , vitamin D, Metoprolol , Dexamethasone , Levothyroxine, Lexapro ,Lisinopril.  the patient had certain medical history : Renal Cell Carcinoma on Chemotherapy , Hypertension , Hypothyroidism and Type 2 Diabetes Mellitus.  Concurrent medical conditions included Renal cell carcinoma (on chemotherapy), Hypertension, Hypothyroidism, Type 2 diabetes mellitus, Critical illness and Penicillin allergy. Concomitant products included AMLODIPINE BESILATE (NORVASC), METOPROLOL, DEXAMETHASONE, LEVOTHYROXINE, ESCITALOPRAM OXALATE (LEXAPRO), LISINOPRIL and VITAMIN D NOS for an unknown indication.    On 24-Mar-2021 at 11:00 AM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Mar-2021, the patient experienced FEEDING DISORDER (Poor PO intake following the vaccine). On 25-Mar-2021 at 11:00 PM,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DYSPNOEA (Shortness of breath), PYREXIA (Fever), MYALGIA (Myalgia) and FATIGUE (Fatigue). On 26-Mar-2021, the patient experienced ACUTE MYOCARDIAL INFARCTION (NSTEMI) (seriousness criteria medically significant and life threatening), SEPTIC SHOCK (Septic shock) (seriousness criteria medically significant and life threatening), RESPIRATORY FAILURE (Hypoxic respiratory) (seriousness criteria medically significant and life threatening), HYPERKALAEMIA (Hyperkalemic) (seriousness criterion medically significant), PNEUMONIA (Bilateral pneumonia) (seriousness criterion medically significant) and ACUTE KIDNEY INJURY (Acute renal failure) (seriousness criterion medically significant). On 26-Mar-2021, ACUTE MYOCARDIAL INFARCTION (NSTEMI), SEPTIC SHOCK (Septic shock), RESPIRATORY FAILURE (Hypoxic respiratory), HYPERKALAEMIA (Hyperkalemic), PNEUMONIA (Bilateral pneumonia) and ACUTE KIDNEY INJURY (Acute renal failure) outcome was unknown. At the time of the report, DYSPNOEA (Shortness of breath), FEEDING DISORDER (Poor PO intake following the vaccine), PYREXIA (Fever), MYALGIA (Myalgia) and FATIGUE (Fatigue) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Mar-2021, Chest X-ray: abnormal (abnormal) Severe bilateral pneumonia. On 26-Mar-2021, Electrocardiogram: abnormal (abnormal) ST depression on V2-V4. On 26-Mar-2021, Troponin: 8.496 (High) High. On 26-Mar-2021, pH body fluid: 7.12 (abnormal) Abnormal.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   The patient expired with in hours of arrival to the ER despite full attempts at resuscitation.  Treatment for the events included resuscitation. Based on the current available information and temporal association between the use of the product and the events, a causal relationship cannot be excluded, although it is likely the patient's underlying critical state caused or contributed to the events.  The cause of death is not specifically reported and event of death retained separately, although likely caused by MI, septic shock, respiratory failure, or a combination of these events; Sender's Comments: Based on the current available information and temporal association between the use of the product and the events, a causal relationship cannot be excluded, although it is likely the patient's underlying critical state caused or contributed to the events.  The cause of death is not specifically reported and event of death retained separately, although likely caused by MI, septic shock, respiratory failure, or a combination of these events