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

This is VAERS ID 1048270



Case Details

VAERS ID: 1048270 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2020-12-31
Onset:2021-01-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-23
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: 2021-01-16
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical health deterioration; Living in nursing home (There was a covid-19 outbreak among several residents and staff)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: DKPFIZER INC2021158644

Write-up: Death with COVID-19/COVID-19 virus test, Jan2021, positive; Death with COVID-19/COVID-19 virus test, Jan2021, positive; This is a spontaneous report from a contactable physician received from the Medicines Agency. Regulatory authority report number DK-DKMA-WBS-0032136. A 91-year-old female patient received the first dose bnt162b2 (COMIRNATY, Batch number/lot number: EJ6797), intramuscular on 31Dec2020 at single dose for covid-19 immunization. The patient''s concurrent conditions included general physical health deterioration, the patient was living in nursing home, where there was a covid-19 outbreak among several residents and staff. The patient''s concomitant medications were not reported. The patient experienced covid-19 in Jan2021. The patient underwent lab tests and procedures which included COVID-19 virus test: positive in Jan2021. The patient died on 16Jan2021. An autopsy was not performed. Reported cause of death was death with COVID-19. The outcome was fatal.; Reported Cause(s) of Death: Death with COVID-19/COVID-19 virus test, Jan2021, positive; Death with COVID-19/COVID-19 virus test, Jan2021, positive


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