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

This is VAERS ID 1161786



Case Details

VAERS ID: 1161786 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-07
Onset:2021-03-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2166-12-026 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-10
   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: LEVOTHYROXINE; ENALAPRIL; AMLODIPINE; SIMVASTATIN; NEBIVOLOL; SILODOSIN; RIVAROXABAN; OMEPRAZOLE
Current Illness: AFib; Artificial cardiac pacemaker wearer (total BAV pacemaker); Atrioventricular block; Hypercholesteremia; Hypertensive heart disease; Hypothyroidism (hypothyroidism in replacement treatment); Overweight
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITPFIZER INC2021311573

Write-up: The patient died on 10Mar2021 , on 07Mar2021 had been subjected to the second dose of the Pfizer vaccine; This is a spontaneous report from contactable physician downloaded from the Regulatory Authority. The regulatory authority number is IT-MINISAL02-699985. An 83-year-old male patient received the second dose of BNT162B2 (COMIRNATY, lot number: EP2166-12-026) at the age of 83-years-old, intramuscular on 07Mar2021 at 0.3 mL, single for COVID-19 immunisation. Medical history included ongoing hypertensive heart disease, atrial fibrillation (AFib), atrioventricular block, artificial cardiac pacemaker wearer (total BAV pacemaker), hypercholesterolemia, hypothyroidism in replacement treatment, and overweight. Concomitant medications included levothyroxine, enalapril, amlodipine, simvastatin, nebivolol, silodosin, rivaroxaban, and omeprazole. The patient passed away on 10Mar2021. The patient was living alone. The corpse was found sitting in an armchair in front of the television in the late morning of 10Mar2021. At the arrival of the doctor, around 1 pm, the patient already had signs of rigor mortis therefore presumably death occurred early in the morning of Wednesday, 10Mar2021. The patient died on 10Mar2021. The cause of death was unknown. Autopsy was not performed. Reporter''s comment: Mr. PRIVACY was suffering from hypertensive heart disease, atrial fibrillation, total BAV pacemaker, hypercholesterolemia, hypothyroidism in replacement treatment, overweight. Mr. PRIVACY , born on PRIVACY, passed away on March 10, 2021. On March 7, he received the second dose of the Pfizer vaccine. The patient, who lived alone, was already found dead, sitting in an armchair in front of the television, in the late morning of 10 March. Upon my arrival, around 1 pm, the deceased present. Sender''s comments: On 16Mar21, the clinical report is attached, the fields updated with new information, the death field privacy filled in. No follow-up attempts are possible. No further information is expected.; Reporter''s Comments: Mr. PRIVACY was suffering from hypertensive heart disease, atrial fibrillation, total BAV pacemaker, hypercholesterolemia, hypothyroidism in replacement treatment, overweight. Mr. PRIVACY , born on PRIVACY, passed away on March 10, 2021. On March 7, he received the second dose of the Pfizer vaccine. The patient, who lived alone, was already found dead, sitting in an armchair in front of the television, in the late morning of 10 March. Upon my arrival, around 1 pm, the deceased present.; Reported Cause(s) of Death: The patient died on 10Mar2021 , on 07Mar2021 had been subjected to the second dose of the Pfizer vaccine


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