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

This is VAERS ID 1273487



Case Details

VAERS ID: 1273487 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-01-28
Onset:2021-01-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Bedridden, Biopsy, Chills, Computerised tomogram abnormal, Death, Fatigue, Headache, Lung neoplasm malignant, Magnetic resonance imaging abnormal, Neoplasm malignant, Pain, Pyrexia, X-ray abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-10
   Days after onset: 71
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data: Multiple MRI''s, CAT scans, xrays, biopsy
CDC Split Type:

Write-up: Fever greater than 103; body aches; chills; extreme fatigue; severe headache; gradually increasing back pain Back pain increased every day. About 3 weeks after vaccine shot, he went to doctor. Back pain continued til he was bedridden bc of severe pain. Went to ER March 22. Tests showed cancer in lungs and hip. Died April 10


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