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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1298640

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Case Details

VAERS ID: 1298640 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-13
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 2243 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: General physical health deterioration
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: PLPFIZER INC2021497078

Write-up: health deteriorated; This is a spontaneous report from a contactable consumer received by email. This consumer reported two different cases for two patients. This is 1st of 2 reports, describing events for male patient. A male patient of an unspecified age received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 13Apr2021 (Batch/Lot Number: EW 2243) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient health deteriorated after vaccination, as a result patient died. Therefore, the reporter wanted to report an adverse reaction of a conditionally approved vaccine. The reporter had already reported the situation to Regulatory Authority and would like to inform company that an e-mail of similar content will be sent to the company''s headquarters. No further information was provided.; Reported Cause(s) of Death: health deteriorated


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