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

This is VAERS ID 1044978



Case Details

VAERS ID: 1044978 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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: 2021-01-22
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19; General physical health deterioration; Living in nursing home
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158635

Write-up: Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient; Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient; This is a spontaneous report from a non-contactable physician downloaded from the Agency Regulatory Authority-WEB DK-DKMA-WBS-0032140. An 85-year-old male patient received first dose of bnt162b2 (COMIRNATY, lot number: EJ6797), via intramuscular on 31Dec2020 at single dose for COVID-19 immunisation. The relevant medical history included living in nursing home, COVID-19, general physical health deterioration, all from unspecified dates and ongoing. Concomitant medications were not reported. The physician reported the occurrence of death. It was not inconceivable that the total liability of Covid-19 disease and the vaccination had been fatal for the patient. No treatment due to the event was reported. On 22Jan2021 the patient died. The reported cause of death was of/with COVID-19. The autopsy was not performed. Only usual confirmation of death was performed post-mortem. No findings were reported. The patient underwent lab test included COVID-19 virus test which showed positive in Jan2021. The outcome of the event was fatal. No follow-up attempts are needed. No further information is expected.; Reported Cause(s) of Death: Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient; Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the pat


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