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

This is VAERS ID 1218848



Case Details

VAERS ID: 1218848 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Death
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Lexapro, Actos, Lopressor, Lasix, Risperdal, Prilosec, Metformin, Lipitor, Lisinopril, Tresiba, Glipizide, Vit D
Current Illness: Doing okay otherwise. Lisinopril was increased 2 days before death due to elevated blood pressure.
Preexisting Conditions: DM2, HTN, HPL h/o traumatic head injury years ago, depression, GERD, HPL
Allergies: None
Diagnostic Lab Data: Was evaluated in hospital ER. Died after presentation. Not sure if any tests were done as he was distressed on arrival per report.
CDC Split Type:

Write-up: Angioedema on 4/2/21 leading to death


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1218848

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