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

This is VAERS ID 1045500



Case Details

VAERS ID: 1045500 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-01
Onset:2021-01-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6796 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Cardiac failure, Death, Peripheral swelling, Seizure
SMQs:, Cardiac failure (narrow), Angioedema (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: Chronic subdural hematoma; Fibrillation cardiac NOS; Hypertension; Myocardial infarct; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: SEPFIZER INC2021158466

Write-up: Died after vaccination; repeated absence attacks that turned into seizures; Heart failure; Swollen legs; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency (MA) Regulatory Authority-WEB, Regulatory Authority number SE-MPA-2021-003164. Other case identifier number SE-MPA-1612855306187. A 79-year-old male patient received bnt162b2 (COMIRNATY) (Batch/lot number: EJ6796) intramuscularly in Jan2021 at 0.3 ml single for COVID-19 immunisation. Medical history included type 2 diabetes mellitus, cardiac fibrillation, hypertension, chronic subdural hematoma and a previous myocardial infarction. Concomitant medications were not reported. The reported adverse reaction is died in Jan2021 after vaccination. The patient began to have repeated absence attacks that turned into seizures, became uncontactable. Swollen legs. Heart failure was suspected. Treatment with Furix given. They deduced this to previous myocardial infarction and cardiac fibrillation. As well as the absence attacks to his subdural hematoma. However, it is unclear whether any of the above may have been exacerbated by vaccination, the reporter states. The outcome of events repeated absence attacks that turned into seizures, Swollen legs, Heart failure was unknown. The patient died 16 days after Comirnaty. It was unknown if an autopsy was performed or not. Report assessed event died after vaccination as serious, death. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Unknown cause of death


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