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

This is VAERS ID 1072559

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Case Details

VAERS ID: 1072559 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-15
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Lack of efficacy/effect (narrow), 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: COVID-19
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210125; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:Positive
CDC Split Type: ATPFIZER INC2021221810

Write-up: COVID-19 PCR test Positive; COVID-19 respiratory infection; COVID-19 PCR test Positive/COVID-19 respiratory infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB and received via Regulatory Authority AT-BASGAGES-2021-04882. A 93-year-old female patient received first dose of BNT162B2 (COMIRNATY, lot number EL1491), via an unspecified route of administration on 15Jan2021 at single dose for COVID-19 immunization. Medical history included ongoing COVID-19 Infection. Concomitant medications were not reported. In Jan2021 the patient experienced COVID-19 respiratory infection. The patient''s COVID-19 PCR test was Positive on 25Jan2021. The patient died on 02Feb2021 from COVID-19 respiratory infection. No autopsy was done. The outcome of the events was fatal. Relatedness of Comirnaty to AE assessed by BASGAGES as Unlikely. No follow-up attempts are possible. No further information is expected. Lot/batch number was provided.; Reported Cause(s) of Death: COVID-19 respiratory infection


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