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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1426471

Case Details

VAERS ID: 1426471 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Indiana  
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Death, Nucleic acid test, Polymerase chain reaction, Small intestinal obstruction, Small intestine carcinoma
SMQs:, Gastrointestinal obstruction (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-02
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Small-bowel obstruction Carcinoma of small-bowel
Diagnostic Lab Data: RT-PCR or other NAAT test
CDC Split Type:

Write-up: Death 5/2/2021 Causes of death listed on death certificate: 1) Small-bowel obstruction 2) Carcinoma of small-bowel

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