From the 4/26/2024 release of VAERS data:

This is VAERS ID 930876

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Case Details

VAERS ID:	930876 (history)
Form:	Version 2.0
Age:	88.0
Sex:	Male
Location:	Texas

Vaccinated:	2021-01-07
Onset:	2021-01-08
Days after vaccination:	1
Submitted:	0000-00-00
Entered:	2021-01-08

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA	027L20A / 1	RA / IM

Administered by: Pharmacy Purchased by: ?
Symptoms: Death, X-ray with contrast
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-08
Days after onset: 0
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: Prostate Cancer
Allergies:
Diagnostic Lab Data: Had IV dye imaging procedure after he received the COVID-19 vaccine (the same day in the afternoon) and passed away overnight.
CDC Split Type:

Write-up: Death

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=930876