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

This is VAERS ID 1065050



Case Details

VAERS ID: 1065050 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-29
Onset:2021-01-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM 0477 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-29
   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: AMLODIPINE; PERINDOPRIL ARGININE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NLPFIZER INC2021202398

Write-up: The person concerned has suffered a CVA and died on 29/01; This is a spontaneous report a contactable physician downloaded from the Regulatory Authority-WEB [regulatory authority NL-LRB-00446641] A 99-years-old female patient received first dose of bnt162b2 (COMIRNATY, Lot number: EM 0477), via an unspecified route of administration on 29Jan2021 at single dose for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included amlodipine, perindopril arginine. The patient experienced the person concerned has suffered a cva and died on 29/01 on 29Jan2021. The patient deceased within 1 day after vaccination. The patient died on 29Jan2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reporter''s Comments: BioNTech/Pfizer vaccin (Comirnaty) -Past drug therapy BioNTech/Pfizer vaccin (Comirnaty): no ---------- COVID19 -Previous COVID-19 infection: No Other -diagnostic procedures: no; Reported Cause(s) of Death: CVA


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