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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1156845



Case Details

VAERS ID: 1156845 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-03-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-27
   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: diprosone 0.05% cream, estradiol vaginal cream
Current Illness: none known
Preexisting Conditions: no info in chart
Allergies: none none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received COVID vaccine 3/23/2021. The family called the vaccination clinic to inform that the patient died on 3/27/2021. Family believes the vaccine caused the death. I have no other information on this chart.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1156845


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