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

This is VAERS ID 1151834



Case Details

VAERS ID: 1151834 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-03
Onset:2021-03-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2166 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Gastrointestinal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: Medical History/Concurrent Conditions: Cardiovascular disease, unspecified; Diabetes; Diarrhea; Weight loss
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021333521

Write-up: Hemorrhage of gastrointestinal tract, unspecified; This is a spontaneous report received from a contactable consumer or other non-HCP downloaded from the Regulatory Authority-WEB. The regulatory authority report number is FR-AFSSAPS-LM20210562. Verbatim: Not medically confirmed. Patient notification Lot no EP2166, 1st dose 03Mar2021, left arm. Medical History, current diseases, context : COVID-19 disease history: NO, diabetes and cardiovascular disease. Description of Adverse Effect: Death of digestive hemorrhage on D3 of vaccination. The patient who lost weight due to diarrhea for a few weeks before vaccination. Brief observation, no further information available. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Hemorrhage of gastrointestinal tract, unspecified


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