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

This is VAERS ID 1213634



Case Details

VAERS ID: 1213634 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-12
Onset:2021-03-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Arthralgia, Headache, Influenza like illness, Nausea, Oropharyngeal pain
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-30
   Days after onset: 12
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: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: CZPFIZER INC2021389788

Write-up: Infarct; nausea; headache; joint pain; Flu-like symptoms; Sore throat; This is a spontaneous report from a contactable consumer downloaded from a regulatory authority- CZ-CZSUKL-21003489. An 85-year-old male patient received first dose of BNT162B2 (COMIRNATY; lot number and expiry date were unknown), intramuscular on 12Mar2021 at a single dose for COVID-19 immunization. Medical history included COVID-19 in early Dec2020, no difficult course, no hospitalization, infection detected by accident after admission to the spa, no health consequences and no health problems. Concomitant medications were not reported. On 18Mar2021, the patient began to experience symptoms of nausea, headache and joint pain reported as flu-like symptoms and sore throat. On 22Mar2021, the medical condition was resolved with a district physician who started antibiotic treatment. Outcome of the events nausea, headache, joint pain, flu-like symptoms and sore throat was recovered on 22Mar2021. The patient died on 30Mar2021 and the doctor stated a heart attack resulting in death, also reported as infarct/acute myocardial infarction. An autopsy was not performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Infarct myocardial


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