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

This is VAERS ID 1037317



Case Details

VAERS ID: 1037317 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-01-11
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: BEPFIZER INC2021166348

Write-up: Contamination spread to 34 residents and 13 deaths to be mourned / patient had COVID-19 with fatal outcome; Contamination spread to 34 residents and 13 deaths to be mourned / patient had COVID-19 with fatal outcome; This is a spontaneous report from a contactable physician. This physician reported similar events for thirteen patients. This is the 8th of thirteen reports. A patient of unspecified age and gender received bnt162b2 (COMIRNATY, lot number and expiration date not reported), via an unspecified route of administration on 11Jan2021 at single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 22Jan2021, the physician reported an outbreak of covid-19 infection in the retirement home where the physician was working. It was further reported that the contamination spread to 34 residents and 13 deaths to be mourned. The patient experienced COVID-19 on an unspecified date with fatal outcome. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: The association between the event lack of effect (fatal COVID-19) with COMIRNATY use can not be fully excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : BE-PFIZER INC-2021160947 Same reporter/product/event, different patient; Reported Cause(s) of Death: Contamination spread to 34 residents and 13 deaths to be mourned / patient had COVID-19 with fatal outcome; Contamination spread to 34 residents and 13 deaths to be mourned / patient had COVID-19 with fatal outcome


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1037317

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