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

This is VAERS ID 1045028



Case Details

VAERS ID: 1045028 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-02
Onset:2021-02-03
   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 EJ6788 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Intracranial haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-03
   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: Medical History/Concurrent Conditions: AFib; Alzheimer''s disease; Anxiodepressive syndrome; Behaviour disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021159196

Write-up: Intracranial haematoma; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) Regulatory authority-WEB FR-AFSSAPS-PO20210283. An 85-year-old female patient received her first dose of bnt162b2 (COMIRNATY, lot EJ6788), intramuscularly on left arm on 02Feb2021 at single dose for COVID-19 immunization. Medical history included Alzheimer''s disease, Anxiodepressive syndrome, behaviour disorder, atrial fibrillation (AFib). The patient''s concomitant medications were not reported. On 03Feb2021, the patient was unwell. No particular symptoms, no change in general condition or behavior between vaccination and malaise. The patient was hospitalized urgently. An intracranial hematoma was detected. The evolution was rapidly pejorative leading to the death of the patient. The report was under investigation. The patient did not have COVID-19. She had not been tested. The patient died on 03Feb2021. It was unknown if an autopsy was performed. No follow-up attempts possible. No further information expected. Batch/lot number already obtained.; Reported Cause(s) of Death: Intracranial haematoma


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