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

This is VAERS ID 1099629



Case Details

VAERS ID: 1099629 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-25
Onset:2021-01-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Decreased appetite, Lung disorder
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-29
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COPD; Emphysema; Fibrosis NOS
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021250308

Write-up: WATER IN LUNGS; Pain chest; Appetite lost; This is a spontaneous report from a contactable consumer or other non hcp downloaded from the regulatory authority-WEB Regulatory Authority number FR-AFSSAPS-BS20210274. A 81-years-old male patient received the first dose of bnt162b2 (COMIRNATY, lot#unknown), via an unspecified route of administration single dose on 25Jan2021 for covid-19 immunisation. Medical history included ongoing chronic obstructive pulmonary disease, ongoing emphysema, ongoing fibrosis. The patient''s concomitant medications were not reported. The patient experienced water in lungs (lung disorder) (death) on 29Jan2021, appetite lost (decreased appetite) (death) on 25Jan2021, pain chest (chest pain) (death) on 28Jan2021. They punctured the water out of his lungs so that he wouldn''t suffer so much. They put him in a room sitting up and secured him with pillows. He had a coherent speech and seemed calm. An hour later, they found him dead in the bed. He died in the emergency room on Friday 29Jan2021 at 3:15 am. An autopsy was not performed. No follow-up attempts are possible. Information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: water in lungs; appetite lost; pain chest


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