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From the 4/30/2021 release of VAERS data:

This is VAERS ID 1116540



Case Details

VAERS ID: 1116540 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-15
Onset:2021-03-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-18
   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: JANUVIA 50MG, DULOXETINE 60MG, HYDROXYZINE PAMOATE 25MG, BUPROPION XL 300MG, TRAZODONE 100MG, WAFARIN 6MG, EZETIMIBE 10MG, WARFARIN 1MG, ATORVASTATIN 40MG, GABAPENTIN 400MG,
Current Illness: UNKNOWN
Preexisting Conditions: DIABETES, COPD, CHRONIC KIDNEY DISEASE, CHRONIC PAIN DISEASE, THYROID DISORDER, DEPRESSION/ANXIETY
Allergies: PENICILLIN, SULFA ANTIOBIOTICS
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: DEATH- PHARMACY NOTIFIED 3/19/21 OF PATIENT DEATH ON 3/18/21, NO OTHER DETAILS KNOWN


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