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

This is VAERS ID 1174530



Case Details

VAERS ID: 1174530 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-18
Onset:2021-03-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3620 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Death, Disease recurrence, Hypertension, Oxygen saturation, Sense of oppression
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-22
   Days after onset: 1
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: Arterial hypertension; COVID-19; Diabetes
Allergies:
Diagnostic Lab Data: Test Name: Oxygen saturation; Result Unstructured Data: Test Result:correct
CDC Split Type: FRPFIZER INC2021358154

Write-up: Sense of oppression; weakness; Death NOS; Hypertension arterial; Hypertension arterial; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number FR-AFSSAPS-MA20211046. A 77-year-old female patient received BNT162B2 (COMIRNATY; lot number: ET3620), via intramuscular route of administration on 18Mar2021 (at the age of 77 years) at a single dose for COVID-19 immunization. Medical history included COVID-19, diabetes, and arterial hypertension. The patient''s concomitant medications were not reported. The patient experienced hypertension arterial on 21Mar2021; sense of oppression and weakness on 22Mar2021; and death NOS on 22Mar2021. The patient underwent lab test which included correct oxygen saturation on an unspecified date. The patient died on 22Mar2021 due to the events. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: weakness; Death NOS; Hypertension arterial; Hypertension arterial; Sense of oppression


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