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

This is VAERS ID 1100051



Case Details

VAERS ID: 1100051 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-17
Onset:2021-02-17
   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 EJ6790 / 2 RL / OT

Administered by: Other       Purchased by: ?
Symptoms: Death, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-20
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CLEXANE; TIAPRIDAL; CAVINTON FORTE; FRONTIN; COVEREX AS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Dementia; Femoral neck fracture; Flutter atrial; Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: HUPFIZER INC2021244072

Write-up: death; intramuscular at 0.3 mL, single in the right thigh; This is a spontaneous report from a contactable consumer downloaded from the regulatory authority-WEB, regulatory authority number HU-OGYI-096021. An 83-year-old female patient received the second dose of bnt162b2 (COMIRNATY) (Lot # EJ6790), intramuscular at 0.3 mL, single in the right thigh on 17Feb2021 for COVID-19 immunisation. Medical history included atrial fibrillation and flutter, dementia, hypertension, and bilateral femoral neck fracture in 2014 and in 2017. Concomitant medication included enoxaparin sodium (CLEXANE), tiapride hydrochloride (TIAPRIDAL), vinpocetine (CAVINTON FORTE), alprazolam (FRONTIN), perindopril arginine (COVEREX AS). Previously the patient received the first dose of Comirnaty (Lot # EJ6134) intramuscular in the left arm on 27Jan2021 for COVID-19 immunisation. The patient experienced death on 20Feb2021. The patient died on 20Feb2021. It was not reported if an autopsy was performed. Sender Comment: The 83 year-old patient died 3 days after Comirnaty vaccination. There is no information about the cause of death or whether autopsy was done. The causal relationship between the reported death and Comirnaty was unassessable. The case is serious due to fatal outcome. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: death


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