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

This is VAERS ID 1094681



Case Details

VAERS ID: 1094681 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-25
Onset:2021-02-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN1194 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Asthenia, Blood pressure measurement, Fatigue, Heart rate, Vaccination site pain
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-03
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic alcoholism (years of evolution until reaching the state of drunk, even the days that he was vaccinated)
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; Diabetes mellitus (for more than 20 years uncontrolled); Gastric cancer (8 years of evolution with no treatment)
Allergies:
Diagnostic Lab Data: Test Date: 20210303; Test Name: Blood pressure; Result Unstructured Data: Test Result:without blood pressure; Test Date: 20210303; Test Name: pulse; Result Unstructured Data: Test Result:without pulse
CDC Split Type: MXPFIZER INC2021253671

Write-up: Acute myocardial infarction; Asthenia/Fatigue; Asthenia/Fatigue; pain on the application site; This is a spontaneous report from a non-contactable healthcare professional received from Regulatory Authority. Regulatory authority number 10501. A 57-year-old male patient received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EN1194, expiration date: 01Jun2021) intramuscular, in left arm, on 25Feb2021, for COVID-19 immunisation. Medical history included arterial hypertension, diabetes mellitus for more than 20 years uncontrolled, gastric cancer (8 years of evolution with no treatment), chronic alcoholism (years of evolution until reaching the state of drunk, even the days that he was vaccinated). Allergies: no. Treatment: metoprolol, metformin, glibenclamide. Concomitant medications were not reported. The patient experienced pain on the application site on 25Feb2021. The patient experienced acute myocardial infarction and asthenia/fatigue on 03Mar2021. The family members referred that after the administration of the first dose on 07Feb2021, the patient presented pain on the application site and mild headache, and that same day, drank alcoholic beverages until drunkenness, that leaded to visual hallucinations, on the second day of the application only said that felt tired on the 3rd day without symptomatology. About the administration of the second dose on 25Feb2021, the family members only referred that the patient had pain on the application site and that lasted only one day without another symptoms. The patient went to his work activities without any symptoms on 01Mar2021 and 02Mar2021, without clinical manifestations. On 03Mar2021, he was carrying out his activities in the health center normally, mentioned going to the restroom, around 12.00, approximately at 20 min, a companion also entered the bathroom when realizing that he was busy, spoke to him on repeated occasions, for which he went to the authorities of the health center. The door was opened, finding him unconscious with mydriasis and pupils without response to luminous stimulations, with cold skin, without pulse or blood pressure. Basic resuscitation maneuvers were performed without positive result. Patient with a history of arterial hypertension and diabetes mellitus for more than 20 years uncontrolled. The family members corroborated that he had been diagnosed with gastric cancer of 8 years of evolution with no treatment, besides of chronic alcoholism with years of evolution until reaching the state of drunk, even the days that he was vaccinated. The patient died on 03Mar2021. Myocardial infarction was reported with a fatal outcome. Pain on the application site resolved on 26Feb2021. Asthenia/fatigue outcome was unknown. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : MX-PFIZER INC-2021257759 Same patient/vaccine, different dose and AE; Reported Cause(s) of Death: Acute myocardial infarction


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