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From the 2/18/2021 release of VAERS data:

This is VAERS ID 115514

Case Details

VAERS ID: 115514 (history)  
Form: Version 1.0  
Age: 86.0  
Sex: Female  
Location: Mississippi  
Vaccinated:1998-10-19
Onset:1998-10-19
   Days after vaccination:0
Submitted: 1998-10-21
   Days after onset:2
Entered: 1998-11-02
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20158HG / 6 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arteriosclerosis, Cardiovascular disorder
SMQs:, Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-10-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: when asked if sick of feeling bad;pt did not report any problems
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: MS98022

Write-up: pt recv vax approx 830AM & pt pronounced dead on front steps of home;between 1:00 & 2PM 19OCT98 by medical examiner;


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=115514


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