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

This is VAERS ID 1361035



Case Details

VAERS ID: 1361035 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-16
Onset:2021-03-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: ADAMTS13 activity normal, Carcinoembryonic antigen increased, Catheterisation cardiac, Death, Dyspnoea exertional, Echocardiogram abnormal, Microangiopathic haemolytic anaemia, Pulmonary hypertension, Vasodilatation
SMQs:, Haemolytic disorders (narrow), Tumour markers (narrow), Pulmonary hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-29
   Days after onset: 71
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MVT
Current Illness: anxiety, h/o limited stage colon CA s/p resection 2016
Preexisting Conditions: none
Allergies: PCN
Diagnostic Lab Data: multiple Right heart cath and echo trial of PLEX ADAMTS level wnl multiple echo CEA very elevated 221
CDC Split Type:

Write-up: 3 days post vaccine, patient developed progressive DOE. Ultimately dx with microagiopathic hemolytic anemia and severe pulmonary HTN thought to be pre- and post capillary. TTP ruled out with normal ADAMTS 13, attempted IV vasodilation but ultimately died.


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