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

This is VAERS ID 1172840



Case Details

VAERS ID: 1172840 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-03
   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: memantine, pantoprozole, Linzess, Cymbalta, Fluoxetine, levothyroxine, trazadone,
Current Illness: fibromyalgia, chronic smoldering depression,, hyperlipidemia, mild memory loss
Preexisting Conditions: hypothyroid
Allergies: codeine
Diagnostic Lab Data: none. Pronounced dead at the scene in her home.
CDC Split Type:

Write-up: She received vaccination at 1430 hrs on April 2. Died in her sleep that night...sometime between 2200 hrs April 2 and 0600 hrs April 3.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1172840

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