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

This is VAERS ID 1174826



Case Details

VAERS ID: 1174826 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2659 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210401; Test Name: Body temperature; Result Unstructured Data: Test Result:36,4 Centigrade; Comments: before vaccination
CDC Split Type: JPPFIZER INC2021368293

Write-up: Death; This is a spontaneous report from a contactable physician. This is a report received from the Agency. The regulatory authority report number is v21100370. A 62 and 11 month old year-old male patient received BNT162B2 (COMIRNATY; Lot Number: ER2659; Expiration Date: 30Jun2021), dose 2 via an unspecified route of administration on 01Apr2021, at 14:30 as single dose for covid-19 immunization. The patient''s medical history was not reported. The patient reported that he took unspecified oral antithrombotic drug. The patient had no family history. On 11Mar2021, the patient had received the 1st dose of BNT162B2 (Lot number EP2163, Expiration date 31May2021), and had no adverse reaction. The patient experienced death on 02Apr2021. The patient underwent lab tests and procedures which included body temperature: 36,4 Centigrade on 01Apr2021 before vaccination. Details were as follows: On 02Apr2021, in the morning (1 days after the vaccination), the patient died. The outcome of the event was fatal. On 01Apr2021, the day of the vaccination, the patient went home as no abnormality was noted. In the early morning of 02Apr2021, within 24 hours from the vaccination, his death was confirmed at home. The reporting physician classified the death as serious and assessed that the causality between the event and BNT162B2 as unassessable. The reporting physician considered the oral antithrombotic drug the patient reported as other possible causative factor for the event. The patient died on 02Apr2021. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: Death


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