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

This is VAERS ID 1061467



Case Details

VAERS ID: 1061467 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-02
Onset:2021-02-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6134 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Blood pressure measurement, Body temperature, Body temperature increased, Death, Heart rate, Heart rate decreased, Oxygen saturation, Respiratory rate, Respiratory rate decreased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-09
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ZOREEDA; DILATREND; LASIX [FUROSEMIDE]; DULOXETINE; SPIROBENE; NEUPRO; ESOMEPRAZOLE; SINTROM; GABAPENTIN
Current Illness: Cor pulmonale; Multimorbidity; Pulmonary arterial hypertension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:decreased; Test Name: body temperature; Result Unstructured Data: Test Result:38.5 Centigrade; Test Name: HR; Result Unstructured Data: Test Result:drop (less than 40); Test Name: O2 saturation; Result Unstructured Data: Test Result:greater than 90 %; Test Name: RR; Result Unstructured Data: Test Result:drop
CDC Split Type: ATPFIZER INC2021190062

Write-up: O2 saturation; Body temperature increased; Heart rate decreased; Blood pressure decreased; Respiratory rate decreased; Death; This is a spontaneous report from a contactable physician downloaded from the regulatory authority (AT-BASGAGES-2021-01408). An 86-year-old female patient received the second dose of BNT162B2 (COMIRNATY; Lot number: EJ6134), via an unspecified route of administration, on 02Feb2021 at a single dose for COVID-19 immunisation. Medical history included ongoing multimorbidity, ongoing cor pulmonale, and ongoing pulmonary arterial hypertension. Concomitant medications included fluticasone propionate, salmeterol xinafoate (ZOREEDA), carvedilol (DILATREND), furosemide (LASIX), duloxetine (MANUFACTURER UNKNOWN), spironolactone (SPIROBENE), rotigotine (NEUPRO), esomeprazole (MANUFACTURER UNKNOWN), acenocoumarol (SINTROM), and gabapentin (MANUFACTURER UNKNOWN). The patient previously received the first dose of BNT162B2 (COMIRNATY) on an unspecified date for COVID-19 immunization. The patient experienced oxygen (O2) saturation, body temperature increased, heart rate decreased, blood pressure decreased, and respiratory rate decreased on 03Feb2021 at 09:00, which all caused hospitalization. The patient also experienced death on 09Feb2021, which was reported as fatal. The patient underwent lab tests and procedures, all on an unspecified date, which included respiratory rate (RR): drop, body temperature: 38.5 centigrade, heart rate (HR): drop (less than 40), O2 saturation: greater than 90%, and blood pressure: decreased. The clinical outcome of oxygen (O2) saturation, body temperature increased, heart rate decreased, blood pressure decreased, and respiratory rate decreased was not recovered. The patient died on 09Feb2021. The cause of death was reported as unknown. An autopsy was performed, and results were not provided. It was reported that: The autopsy revealed a different cause of death than the vaccination. From the point of view of the pathologist, the contribution of the vaccination to the cause of death cannot be objectified. At the time of the vaccination there were no signs of infection. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: Linked Report(s) : AT-BASGAGES-2021-00233; Reported Cause(s) of Death: Unknown cause of death


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