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

This is VAERS ID 1123078



Case Details

VAERS ID: 1123078 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-02-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Fall, Pain in extremity, Pulmonary mass, Upper limb fracture
SMQs:, Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-16
   Days after onset: 41
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: mass on right lung fall, arm fracture arm pain leg pain death


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1123078

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