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

This is VAERS ID 1061852



Case Details

VAERS ID: 1061852 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-28
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Respiratory disorder, SARS-CoV-2 test
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-02
   Days after onset: 32
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210131; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: NLPFIZER INC2021191346

Write-up: Diagnised by pathologist with COVID-19 but negative test; Respiratory dysfunction; This is a spontaneous report downloaded from the Regulatory Authority-WEB [Lareb (LRB) number NL-LRB-00445009] from a contactable consumer (patient''s daughter or son). An elderly male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration, on 28Jan2021, at single dose, for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient was diagnosed by a pathologist with COVID-19 in Jan2021 but test was negative on 31Jan2021, and experienced respiratory dysfunction in Jan2021. After events onset the patient underwent lab tests and procedures which included COVID-19 virus test: negative on 31Jan2021. The patient died on 02Feb2021. An autopsy was performed and results were not available. Case summary and Reporter comment: My father was vaccinated on 28Jan2021. Sadly died on 02Feb2021 from the effects of the vaccine, he was chronically short of oxygen and his lungs stopped functioning. I have come into conflict with the pathologist who diagnosed COVID-19. What the pathologist didn''t know was that my father had been tested for COVID-19 after the symptoms started. COVID-19 negative test result was on 31Jan2021. The pathologist, after initial doubts, stayed with his diagnosis of COVID-19 and said it was not contagious (unbelievable), I myself warned the nursing home to take measures, but that was according to not need the pathologist. The pathologist himself reported to the nursing home that the investigation was still ongoing (various signals, miscommunication). No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reporter''s Comments: My father was vaccinated on 28Jan2021. Sadly died on 02Feb2021 from the effects of the vaccine, he was chronically short of oxygen and his lungs stopped functioning. I have come into conflict with the pathologist who diagnosed COVID-19. What the pathologist didn''t know was that my father had been tested for COVID-19 after the symptoms started.; Reported Cause(s) of Death: Respiratory dysfunction; Diagnised by pathologist with COVID-19 but negative test


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