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

This is VAERS ID 1241509



Case Details

VAERS ID: 1241509 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-01
Onset:2021-04-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET7205 / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-03
   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: KEPPRA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib; Anaemia; Cerebral amyloid angiopathy; CVA (stopping anticoagulants since 2017); Deglutition disorder (swallowing disorder with multiple pneumonia); Inflammation (Antritis under proton pump inhibitors); Mixed dementia; Osteoporosis; Partial epilepsy; Pneumonia
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021420744

Write-up: Death unexplained; This is a spontaneous report from a contactable physician downloaded from a regulatory authority FR-AFSSAPS-LY20212870 and received via a regulatory authority. A 90-year-old female patient received first dose of bnt162b2 (COMIRNATY, Lot: ET7205) intramuscular in left arm on 01Apr2021 at single dose for COVID-19 immunisation. Medical history included mixed dementia, partial epilepsy, CVA (cerebrovascular accident) and AVC (stroke) from 2000, 2005 and not ongoing, ACFA (AFib ,complete arrhythmia by atrial fibrillation) old, stopping anticoagulants since 2017, deglutition disorder (swallowing disorder with multiple pneumonia), osteoporosis, anaemia, cerebral amyloid angiopathy, antritis under PPI (proton pump inhibitors). No covid history. Concomitant medications included levetiracetam (KEPPRA), PPI proton pump inhibitors (unspecified). On 03Apr2021, in the evening, the patient took her meal in the chair and then went back to bed. 10min later, death was declared. She had no significant acute pathology, and had not presented any signs of vomiting, nor painful facies. The patient experienced unexplained death, the declarant mentions the multiple chronic pathologies that can lead to death, a possible massive stroke, and questions the role of the vaccine. The patient died on 03Apr2021. It was unknown if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death unexplained


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