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

This is VAERS ID 1098902



Case Details

VAERS ID: 1098902 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-02
Onset:2021-02-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-21
   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:
Current Illness: Diabetic, coronary heart disease
Preexisting Conditions: Diabetic, coronary heart disease
Allergies:
Diagnostic Lab Data: Autopsy not done due to known health conditions and no fowl play. Understood that death was likely caused by his Heath issues, but just wanted the death reported in case there are later findings about the vaccines and potential complications.
CDC Split Type:

Write-up: Death


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1098902

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