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Report #2895900

Received May 8, 2026

Died

Reports are unverified and do not show that a vaccine caused an event. Full disclaimer

Overview

Sex
Male
Age
100 yrs
State
IA
Recovered
Unknown
Vaccinated
Apr 23, 2026
Onset
May 8, 2026
Days to onset
15
Hospital days
—

Vaccines (1)

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

Symptoms (1)

Death

Symptom narrative

Resident passed away

Medical history

UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WITH OTHER BEHAVIORAL DISTURBANCE, CHRONIC GOUT, UNSPECIFIED, WITHOUT TOPHUS (TOPHI), CHRONIC KIDNEY DISEASE, STAGE 4 (SEVERE), OTHER VENTRICULAR TACHYCARDIA, PRESENCE OF CARDIAC PACEMAKER, SICK SINUS SYNDROME, PAROXYSMAL ATRIAL FIBRILLATION, OTHER NONRHEUMATIC AORTIC VALVE DISORDERS, ESSENTIAL (PRIMARY) HYPERTENSION, NONRHEUMATIC AORTIC (VALVE) STENOSIS,

Other medications

Allopurinol, Gabapentin, Senexon-S, Furosemide, Acetaminophen, Duloxetine, Refresh eye drops, Donepezil, Aspirin, Clopidogrel, Metoprolol, Polyethylene powder,

Allergies

No known allergies