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

This is VAERS ID 1153732



Case Details

VAERS ID: 1153732 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4242 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Pyrexia, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease; Anemia; Diabetes; Hepatitis C; Hypertension; Hypoalbuminemia
Allergies:
Diagnostic Lab Data:
CDC Split Type: ILPFIZER INC2021330464

Write-up: Died in the emergency room; Fever raised; Wheezing in lungs; This is a spontaneous report from a contactable healthcare professional. A 77-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EK4242; Expiration date was not reported) as a single dose, with route of administration and therapy date unspecified for COVID-19 immunization. Medical history included hepatitis C, Alzheimer''s, hypertension, diabetes, hypoalbuminemia and anemia. The patient''s concomitant medications were not reported. On an unspecified date, days after the vaccination, the patient had fever raised and wheezing in the lungs. The events resulted into an emergency room visit, and the patient was treated with antibiotics. On an unspecified date, the patient had died in the emergency room. The outcome of the events, ''fever'' and ''wheezing in the lungs'', was unknown. It was unknown if an autopsy was performed, and the cause of death was not reported. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: The information provided is very limited and does not allow for a complete medical assessment. Based on current convention, the case of death is assessed as related to BNT162B2 until sufficient information is available to confirm an unrelated cause of death. The patient had multiple comorbidities that may have contributed to patient''s demise. Additional information is needed to better assess this report. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: died in the emergency room


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