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

This is VAERS ID 1104947



Case Details

VAERS ID: 1104947 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-06
Onset:2021-03-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Encephalitis, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-08
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021267042

Write-up: Meningoencephalitis; acute pulmonary failure; This is a spontaneous report downloaded from the Regulatory Authority-WEB, regulatory authority number: DE-PEI-PEI2021003222. A 54-years-old female patient received bnt162b2 (COMIRNATY, Solution for injection), via an unspecified route of administration from 06Mar2021 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 06Mar2021 patient experienced meningoencephalitis (death), acute pulmonary failure (death) on 06Mar2021. Seriousness of the case was death. Outcome of the both events was fatal. The patient died on 08Mar2021. It was not reported if an autopsy was performed. No follow-up attempts needed, follow-up automatically provided by regulatory authority.; Reported Cause(s) of Death: acute pulmonary failure; Meningoencephalitis


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1104947

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