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

This is VAERS ID 1316435

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Case Details

VAERS ID: 1316435 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-22
Onset:2021-04-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3045 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-27
   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:
Current Illness: Parkinson''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021522129

Write-up: Unknown cause of death; This is a spontaneous report received from a non-contactable physician downloaded from the regulatory authority-WEB. The regulatory authority report number is DE-PEI-202100055353. An 81-year-old male patient received 2nd dose of BNT162B2 (COMIRNATY, lot number ET3045) at 0.3 ml single dose on 22Apr2021 for COVID-19 immunisation. Medical history and concurrent conditions included Parkinson''s disease. Concomitant drug was not provided. Historical vaccine included 1st dose of BNT162B2 (COMIRNATY) at 0.3 ml single dose on 25Mar2021 for COVID-19 immunisation. On 27Apr2021 the patient experienced unknown cause of death. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: unknown cause of death


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