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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1043880

Case Details

VAERS ID: 1043880 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Senior Living       Purchased by: ?
Symptoms: Aspiration, Death, Insomnia, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-20
   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: atorvastatin, Vit D3, Vit B12, Plavix, duloxetine, Gabapentin, glipizide, levothyroxine, tolterodine, verapamil, atropine, Flonase, Symbicort, Invega, loperamide, Tylenol, albuterol sulfate
Current Illness: urinary tract infection
Preexisting Conditions: diabetes mellitus with polyneuropathy, schizoaffective disorder, chronic obstructive pulmonary disease, essential hypertension, bipolar disorder, hypothyroidism, history of cerebral infarction, diabetic retinopathy, overactive bladder, Vitamin D deficiency, encephalopathy, chronic kidney disease, seizures
Allergies: iodine, shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received second Moderna COVID-19 vaccination administered in left arm at her assisted living facility by Pharmacist at 1153 on 2/19/2021. Pt was monitored for vaccine reaction with no known adverse reaction. Approximately 18 hours post-vaccine, she was found deceased in her sleep at 0540 on 2/20/21. Per circumstances/pt history, it is presumed that the patient aspirated while sleeping, perhaps secondary to a seizure. Coroner was notified and declined as coroner''s case. VAERS notification being made due to pt death within 24 hours of receiving a vaccine.

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