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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1067874

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Case Details

VAERS ID: 1067874 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-04
Onset:2021-02-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Oropharyngeal pain, Oxygen saturation, Oxygen saturation decreased, SARS-CoV-2 test
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: 2021-02-12
   Days after onset: 5
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: 20210211; Test Name: Oxygen saturation; Test Result: 79 %; Test Date: 20210208; Test Name: COVID-19 PCR test; Test Result: Positive ; Test Date: 20210210; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: NLPFIZER INC2021199231

Write-up: death; COVID-19 positive; low oxygen saturation levels (79%); throat pain; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB NL-LRB-00446680 via Regulatory Authority. A 74-years-old female patient received first dose of BNT162B2 (COMIRNATY), via unknown route of administration on 04Feb2021 at single dose for COVID-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced death on 12Feb2021. It was also reported that COVID-19 positive caused patient death. Three days after vaccination on 07Feb2021, the patient had throat pain. 08Feb2021, COVID-19 PCR test performed and patient tested positive. On 10Feb2021, COVID-19 PCR test was positive. The patient was treated with 5L oxygen, but low oxygen saturation levels (79%) remained on 11Feb2021. Start morphine with restrained policy. On 12Feb2021, the patient deceased. Outcome of the event other event was unknown. It was unknown if an autopsy was done or not. No follow-up attempts are possible; information on batch/lot number cannot be obtained.; Reporter''s Comments: BioNTech / Pfizer vaccine (Comirnaty) Past drug therapy BioNTech / Pfizer vaccine (Comirnaty): no Death Additional information ADR: 04Feb vaccination. 07Feb arise sore throat. 08Feb Covid-19 PCR test performed. 10Feb result: positive. 11Feb low saturation (79%) despite 5 liters of oxygen. Start morphine with restrained policy. 12Feb death BSN available: yes COVID19 Previous COVID-19 infection: disease symptoms: hospitalization; Reported Cause(s) of Death: Covid 19 positive; death


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