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

This is VAERS ID 1259280



Case Details

VAERS ID: 1259280 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-04-05
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Lumbar radiculopathy, Lumbar spinal stenosis, Spinal claudication, Spondylolisthesis
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   Days after onset: 20
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 71 year old male received the Covid shot on 2/27/21 and went to the ED and was admitted on 4/5/2021 and died on 4/25/2021. Lumbar radiculopathy, spondylolisthesis of lumbar region, lumbar stenosis with neurogenic claudication, lumbar spinal stenosis. Please refer to the other details submitted within this report and contact the person who submitted this report via email for additional follow up details and investigation.


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