Report #2898352

Received May 29, 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: 64 yrs
State: IA
Recovered: Unknown
Vaccinated: Apr 8, 2026
Onset: May 29, 2026
Days to onset: 51
Hospital days: —

Vaccines (1)

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

Symptoms (1)

Death

Symptom narrative

resident passed away

Medical history

MALIGNANT NEOPLASM OF UPPER LOBE, RIGHT BRONCHUS OR LUNG, MALIGNANT NEOPLASM OF UPPER LOBE, LEFT BRONCHUS OR LUNG, PERSONAL HISTORY OF TRANSIENT ISCHEMIC ATTACK (TIA), AND CEREBRAL INFARCTION WITHOUT RESIDUAL DEFICITS, UNSPECIFIED ATRIAL FIBRILLATION, PARKINSON'S DISEASE WITHOUT DYSKINESIA, WITHOUT MENTION OF FLUCTUATIONS, ALCOHOLIC HEPATITIS WITHOUT ASCITES, TYPE 2 DIABETES MELLITUS WITH DIABETIC NEUROPATHY, UNSPECIFIED NT,

Other medications

Vitamin D3 , Vitamin B-6, Metoprolol Tartate, Trintellix, Pantoprazole, Metformin, Loratadine, Furosemide, Fluticasone-Propionate, Fluticasone- Salmeterol inhaler, Aripiprazole, Carbidopa-Levodopa, Digoxin, Eliquis, Butrans Transdermal patc

Allergies

Amiodarone, Empagliflozin, Pioglitazone, Imitrex, Sulfa Antibiotics.