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

This is VAERS ID 1180640



Case Details

VAERS ID: 1180640 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abnormal sleep-related event, Asthenia, Death, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 4
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: HTN, HLD, COPD, 1-2 PPD smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/4/21 woke up more tired than usual. Progressed from there, prominent fatigue for the next couple days, slept on the couch on and off for a couple days which was unusual for him. Mild SOA and weakness 4/7/21. Died in his sleep into the morning of 4/8/21.


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