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

This is VAERS ID 1225022



Case Details

VAERS ID: 1225022 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-22
Onset:2021-02-28
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-28
   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:
CDC Split Type: DEPFIZER INC2021398822

Write-up: Unknown cause of death; This is a spontaneous report from a non-contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number DE-PEI-202100032176. A 97-year-old female patient received the second dose of bnt162b2 (COMIRNATY), via an unspecified route of administration on 22Jan2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient had the first dose of bnt162b2 (COMIRNATY) on 31Dec2020 at 0.3 ml for Covid-19 immunisation. On 28Feb2021, the patient died of an unknown cause. An autopsy was not performed. Comirnaty and death was assessed by Regulatory Authority as unclassifiable. No follow-up attempts possible. No further information expected. Batch/lot number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death


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