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Report #2896862

Received May 18, 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
84 yrs
State
IA
Recovered
Unknown
Vaccinated
Apr 22, 2026
Onset
May 16, 2026
Days to onset
24
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13052786IM / LA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, PAROXYSMAL ATRIAL FIBRILLATION, CHRONIC RESPIRATORY FAILURE WITH HYPOXIA, CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED, TYPE 2 DIABETES MELLITUS WITH DIABETIC CHRONIC KIDNEY DISEASE, VENOUS INSUFFICIENCY (CHRONIC) (PERIPHERAL), ABDOMINAL AORTIC ANEURYSM, WITHOUT RUPTURE, UNSPECIFIED, VASCULAR DEMENTIA, UNSPECIFIED SEVERITY, WITHOUT BEHAVIORAL DISTURBANCE, PSYCHOTIC DISTURBANCE, MOOD DISTURBANCE, AND ANXIETY, NONALCOHOLIC STEATOHEPATITIS (NASH), CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED

Other medications

Miralax powder, Trazodone, Tramadol, Furosemide, Senexon-S, Metformin, Refresh drops, Melatonin, Atorvastatin, Eliquis, Stiolto Respimat Inhaler, Jardiance, Nasal Decongestant spray, Duloxetine, Guaifenesin, Asper creme/Aloe external cream,

Allergies

Haloperidol, Lisinopril, Tetracycline, Demerol