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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1122501



Case Details

VAERS ID: 1122501 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   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: large right pleural effusion about 1 month ago
Preexisting Conditions: severe arthritis of the right knee hypertension Stage 3 chronic kidney disease Primary osteoarthritis of both knees Nonrheumatic tricuspid valve regurgitation Mitral valve insufficiency, unspecified etiology Pulmonary hypertension Diastolic dysfunction
Allergies: ASPIRIN; PENICILLINS
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient expired next day


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