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

This is VAERS ID 1225028



Case Details

VAERS ID: 1225028 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-26
Onset:2021-03-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebral haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-25
   Days after onset: 21
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 INC2021398819

Write-up: Cerebral haemorrhage; This is a spontaneous report from a non-contactable physician downloaded from a regulatory authority-WEB DE-PEI-202100032189. A 90-year-old male patient received bnt162b2 (COMIRNATY; lot number and expiration date unspecified), via an unspecified route of administration on 26Feb2021 as 0.3 mL, single for COVID-19 immunisation. Medical history was not reported. There were no concomitant medications. On 03Mar2021, the patient experienced cerebral haemorrhage. The patient died on 25Mar2021 due to the event. It was not reported if an autopsy was performed. Relatedness of drug to reaction(s)/event(s) Source of assessment PEI Result of Assessment D. Unclassifiable No follow-up attempts are possible, information on batch/lot number cannot be obtained.; Reported Cause(s) of Death: Cerebral haemorrhage


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