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

This is VAERS ID 1303978

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Case Details

VAERS ID: 1303978 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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: AUPFIZER INC2021495979

Write-up: Haemorrhage; This is a spontaneous report from a contactable other healthcare professional via the regulatory authority. Regulatory authority report number is 543506. A 71-year-old female patient received bnt162b2 (COMIRNATY, lot number was not reported), via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunisation. It was unknown if the patient was pregnant at the time of vaccination. The patient''s medical history and concomitant medications were not reported. The patient experienced haemorrhage on an unspecified date. The outcome of the event was fatal. The patient died on an unspecified date. Cause of death was haemorrhage. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Haemorrhage


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