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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1048386



Case Details

VAERS ID: 1048386 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-28
Onset:2021-02-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-04
   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: APIXABAN; METROGEL; TAMSULOSIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Gout; Malignant melanoma; Comments: Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021166588

Write-up: atrial fibrillation; myocardial infarction; This is a spontaneous report from a contactable physician. This is a report received from the MHRA. Regulatory authority report number GB-MHRA-WEBCOVID-202102121200406190, Safety Report Unique Identifier GB-MHRA-ADR 24748777. A 76-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 28Jan2021 at single dose for COVID-19 vaccination. Medical history included gout from Feb2020, malignant melanoma from Oct2019, atrial fibrillation from Oct2019, all unknown if ongoing. Concomitant medications included apixaban, metronidazole (METROGEL), tamsulosin. The patient experienced myocardial infarction on 04Feb2021 and patient died on 04Feb2021. Cause of death reported as myocardial infarction and atrial fibrillation. An autopsy was performed and results were not available. It was reported that there''s no known causal link to the vaccine, but death occurred in a very close proximity to the vaccine date. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: atrial fibrillation; Myocardial infarction


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