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

This is VAERS ID 1234389



Case Details

VAERS ID: 1234389 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-23
Onset:2021-03-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER9470 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Fatigue, Oxygen saturation, Oxygen saturation decreased, Progressive supranuclear palsy, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Progressive supranuclear palsy
Preexisting Conditions: Medical History/Concurrent Conditions: Embolism pulmonary; Fractured neck of femur; Septicaemia; Thrombosis
Allergies:
Diagnostic Lab Data: Test Date: 20210331; Test Name: Arterial oxygen saturation; Test Result: 75 %; Test Date: 20210331; Test Name: COVID-19 PCR test; Result Unstructured Data: Test Result:negative
CDC Split Type: FRPFIZER INC2021409466

Write-up: worsening of symptoms of an already existing pathology; worsening of symptoms of an already existing pathology; oxygen saturation: 75 % on 31Mar2021; She experienced worsening of her symptoms 4 days after vaccination, associated with fever, difficulty breathing and fatigue.; She experienced worsening of her symptoms 4 days after vaccination, associated with fever, difficulty breathing and fatigue.; She experienced worsening of her symptoms 4 days after vaccination, associated with fever, difficulty breathing and fatigue.; This is a spontaneous report received from a contactable physician downloaded from the Agency Regulatory Authority-WEB. The regulatory authority report number is FR-AFSSAPS-PB20211982. Safety report unique identifier FR-AFSSAPS-2021035447. A 83-years-old female patient received bnt162b2 (COMIRNATY), dose 1 intramuscular on 23Mar2021 (Lot Number: ER9470) as single dose for covid-19 immunisation. Medical history included pulmonary embolism from 2017 to an unknown date, septicaemia from 2017 to an unknown date, fractured neck of femur from 2019 to an unknown date, progressive supranuclear palsy from 2016 and ongoing, thrombosis from 2017 to an unknown date. The patient''s concomitant medications were not reported. The patient previously took modopar, scopoderm [hyoscine], ELIQUIS. The patient experienced worsening of symptoms of an already existing pathology (progressive supranuclear palsy) associated with fever, difficulty breathing and fatigue, all on 27Mar2021, oxygen saturation: 75 % on 31Mar2021. For event worsening of symptoms of an already existing pathology (progressive supranuclear palsy), the patient was taken into emergency care unit and hospitalized from 31Mar2021 to an unknown date. The patient underwent lab tests and procedures which included oxygen saturation: 75 % on 31Mar2021, COVID-19 PCR test: negative on 31Mar2021. The patient died on 01Apr2021 (1 a.m.). It was not reported if an autopsy was performed. The outcome of the event worsening of symptoms of an already existing pathology (progressive supranuclear palsy) was fatal, the outcome of the other events was unknown. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: worsening of symptoms of an already existing pathology (progressive supranuclear palsy); worsening of symptoms of an already existing pathology (progressive supranuclear palsy)


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