Report #2898044

Received May 27, 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: 87 yrs
State: IA
Recovered: Unknown
Vaccinated: Apr 1, 2026
Onset: May 27, 2026
Days to onset: 56
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	—	IM / RA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052786	IM / RA

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE, CHRONIC KIDNEY DISEASE, STAGE 4 (SEVERE), MIXED HYPERLIPIDEMIA, PAROXYSMAL ATRIAL FIBRILLATION, HYPOTHYROIDISM, UNSPECIFIED

Other medications

Terazosin, Acetaminophen, Diclofenac sodium, Sertraline, Fluvastatin, Gvoke PFS, Senexon-S, PreserVision AREDS, Levothyroxine, Jardiance, Eliquis,

Allergies

Atorvastatin, Cholestyramine, Colesevelam, Ezetimibe, Lisinopril, Niacin, Pravastatin, Rosuvastatin, Simvastatin, Sulfamethoxazole/trimethoprim, Sulfa Antibiotics.