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

This is VAERS ID 1215618



Case Details

VAERS ID: 1215618 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Death, Dyspnoea, Myocardial infarction, Pallor
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   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: VITAMIN; CHOLESTEROL TABLET
Current Illness: High cholesterol
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: SGPFIZER INC2021393107

Write-up: On the same day 9pm he suddenly out of breath, cold sweat, turn pale; On the same day 9pm he suddenly out of breath, cold sweat, turn pale; On the same day 9pm he suddenly out of breath, cold sweat, turn pale; died after he had his 1dose of COVID 19 vacation; Doctor immediately attend to him, after half an hour doc came out and said he had heart attack n heart beat has stopped; This is a spontaneous report from a contactable consumer received via a sales representative. An 81-year-old male patient received bnt162b2 (BNT162B2), dose 1 via intramuscular route of administration on 06Apr2021 08:30 (Batch/Lot number was not reported) as an unspecified dose (at the age of 81-year-old) for covid-19 immunisation. The patient medical history included ongoing bit high cholesterol. The patient was healthy and strong. No major sickness before. The patient''s concomitant medications included ongoing vitamins and on cholesterol tablets (drug names not reported). Prior vaccination (within 4 weeks) were none. On 06Apr2021 the patient cycled to and fro to nearby clinic and took his 1st dose of vaccine at 08:30 am. The patient reached home and had his regular meals as per normal. On the same day 9 pm he was suddenly out of breath, cold sweat, turned pale. Immediately, family members called ambulance and rushed him to hospital. The patient was still conscious when he left the house and when reached hospital. Doctor immediately attended to the patient, after half an hour doctor came out and said he had heart attack and heart beat stopped. They cannot retrieve him and the patient died on 06Apr2021. Autopsy was performed and cause of death was ischaemic heart disease. No follow-up attempts are needed, information about lot/batch number cannot be obtained. No further information is expected.; Sender''s Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of events cannot be excluded. The case will be reassessed if additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: ischaemic heart disease


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