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

This is VAERS ID 1153657



Case Details

VAERS ID: 1153657 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-01
Onset:2021-03-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Ischaemic stroke, SARS-CoV-2 test
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-01
   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: Cancer of prostate (Hormonal therapy); Ketosis-prone diabetes mellitus (insulin-dependent diabetes)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20201022; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: FRPFIZER INC2021333492

Write-up: Ischemic stroke; This is a spontaneous report from a contactable physician downloaded from the regulatory authority. An 83-year-old male patient received the second dose of bnt162b2 (COMIRNATY, lot number: EP9598), intramuscular administered in left arm on 01Mar2021 as SINGLE DOSE for COVID-19 immunisation. Medical history included ongoing ketosis-prone diabetes mellitus (insulin-dependent diabetes), COVID-19 history (positive test date 22Oct2020, form presented not provided) from 22Oct2020, and ongoing cancer of prostate (on hormonal therapy). The patient''s concomitant medications were not reported. Historical vaccine includes first dose of bnt162b2 (COMIRNATY) on an unspecified date for COVID-19 immunisation. On 01Mar2021, the patient experienced ischemic stroke leading to the death of the patient on the same day. The patient died on 01Mar2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Ischemic stroke


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