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

This is VAERS ID 1316445

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Case Details

VAERS ID: 1316445 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-26
   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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021527599

Write-up: Unknown cause of death; This is as spontaneous report from a non-contactable physician via Regulatory Authority, downloaded from the regulatory authority-WEB. The regulatory authority report number is DE-PEI-202100058011. A 91-year-old female patient received the second dose of BNT162B2 (COMIRNATY) via an unspecified route of administration on 05Feb2021 (at the age of 90-year-old) (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient received the first dose of BNT162B2 (COMIRNATY) on 15Jan2021 at 0.3 ml single dose for COVID-19 immunisation. The patient experienced unknown cause of death on 26Apr2021. It was not reported if an autopsy was performed. Relatedness of drug to reaction(s)/event(s): Source of assessment: Regulatory Authority: Result of Assessment: D. Unclassifiable. No follow-up attempts are possible, information about batch number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death

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