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

This is VAERS ID 1165291



Case Details

VAERS ID: 1165291 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-28
Onset:2021-01-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6795 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, General physical health deterioration, Rectal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-01
   Days after onset: 31
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bedridden (placed in palliative care); Palliative care
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021342455

Write-up: Deterioration of the general state; rectal bleeding; Diarrhea; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB. Regulatory authority report number FR-AFSSAPS-LM20210585. A 78-year-old female patient received BNT162B2 (COMIRNATY), first dose on 28Jan2021 (Lot Number: EJ6795, unknown expiration) and second dose on 18Feb2021 (Lot Number: EM6950, unknown expiration), both via intramuscular in left arm as a single dose for COVID-19 immunisation. Medical history included bedridden and placed in palliative care. No history of COVID. The patient''s concomitant medications were not reported. It was reported that the patient experienced diarrhea on 29Jan2021 the day after the 1st dose, without real improvement until the 2nd dose when a rectal bleeding was associated on 19Feb2021. The patient had deterioration of the general state on 01Mar2021. The patient died following events diarrhea, bleeding rectal, and deterioration of the general state on 01Mar2021. It was unknown if an autopsy was performed. No follow-up attempts are possible; information about batch number was already obtained.; Reported Cause(s) of Death: Diarrhea; rectal bleeding; Deterioration of the general state


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