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

This is VAERS ID 1065868



Case Details

VAERS ID: 1065868 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-20
Onset:2021-01-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram
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: 2021-01-26
   Days after onset: 2
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: FOLSYRA EVOLAN; ELIQUIS; INCRUSE ELLIPTA; ALLONOL; BETMIGA; FURIX [CEFUROXIME]; BLOXAZOC
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:Large parenchyma hemorrhage in the basal ganglia o; Comments: Large parenchyma hemorrhage in the basal ganglia on the left with breakthrough hemorrhage in the cerebral cortex - blood is present in all four cerebral chambers. High volume effect in the form of displacement of midline structures by 13 mm and a narrowed suprasellar cistern. Imminent uncal herniation and incipient hydrocephalus.
CDC Split Type: ISPFIZER INC2021182071

Write-up: Stroke; This is a spontaneous report from a contactable physician downloaded from the Medicines Agency IS-IMA-1745. An 86-years-old male received bnt162b2 (COMIRNATY), via an unspecified route of administration on 20Jan2021 at SINGLE DOSE for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included folic acid (FOLSYRA EVOLAN 5 mg), apixaban (ELIQUIS 5 mg), umeclidinium bromide (INCRUSE ELLIPTA 55 mcg for inhalation), allopurinol (ALLONOL 100 mg), mirabegron (BETMIGA 25 mg), cefuroxime (FURIX [CEFUROXIME] 20 mg), metoprolol succinate (BLOXAZOC 50 mg) and FINOL 5mg. The patient experienced stroke and was hospitalized on 24Jan2021. The patient died on 26Jan2021 because of the stroke. The event was serious due to hospitalization and death. The patient underwent lab tests and procedures which included CT scan on 24Jan2021: The conclusion from the scan was: Large parenchyma hemorrhage in the basal ganglia on the left with breakthrough hemorrhage in the cerebral cortex - blood is present in all four cerebral chambers. High volume effect in the form of displacement of midline structures by 13 mm and a narrowed suprasellar cistern. Imminent uncal herniation and incipient hydrocephalus. The event outcome was fatal. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected. Batch/Lot numbers can not be obtained.; Reported Cause(s) of Death: Stroke


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