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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1378610

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Case Details

VAERS ID: 1378610 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-30
Onset:2021-03-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3674 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Aortic dissection
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LATANOPROST STADA; VENTOLINE [SALBUTAMOL SULFATE]; GABAPENTIN; VENTOLINE [SALBUTAMOL SULFATE]; PANODIL; CLARITYN [LORATADINE]; FEMAR; PREDNISOLON [PREDNISOLONE]; IMOVANE; CALCIUM & VITAMIN D [CALCIUM;COLECALCIFEROL]; FLIXOTIDE; OXYCODON ACT
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Breast cancer; Glaucoma; Pain; Palliative care (palliative care for breast cancer); Sleeplessness; Urticaria
Allergies:
Diagnostic Lab Data:
CDC Split Type: DKPFIZER INC2021628164

Write-up: Type A aortic dissection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number DK-DKMA-WBS-0065512. A 74-year-old female patient received second dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 30Mar2021 (Lot Number: ET3674; Expiration Date: 31Jul2021) as single dose for COVID-19 immunisation. Medical history included urticaria, pain, sleeplessness, glaucoma, asthma, palliative care (for breast cancer) and breast cancer, all from an unknown date and unknown if ongoing. Concomitant medications included latanoprost (formulation: eye drops, solution, strength: 50ug/ml) ophthalmic taken at 1 drop, daily for glaucoma from 05Dec2019 to an unspecified stop date; salbutamol sulfate (VENTOLINE, formulation: inhalation powder, strength: 0.2 mg) resp inhalation taken at 0.2 mg, daily for asthma from 05Dec2019 to an unspecified stop date; gabapentin (formulation: capsule, hard, strength: 300 mg) oral taken at 900 mg, daily for pain from 05Apr2019 to 07Apr2021; salbutamol sulfate (VENTOLINE, formulation: pressurized inhalation, suspension, strength: 0.1 mg) resp inhalation taken at 0.1 mg, as needed, max 6 times daily for asthma from 04Mar2020 to an unspecified stop date; paracetamol (PANODIL, formulation: film-coated tablet, strength: 500 mg) oral taken at 1000 mg, as needed, max 4 times daily for pain from 15Jul2020 to an unspecified stop date; loratadine (CLARITYN, formulation: tablet, strength: 10 mg) oral taken at 10 mg, as needed, max 1 time daily for urticaria from 05Dec2019 to an unspecified stop date; letrozole (FEMAR, formulation: film-coated tablet, strength: 2.5 mg) oral taken at 2.5 mg, daily for breast cancer from 23Jun2020 to an unspecified stop date; prednisolon [prednisolone] (strength: 5 mg) oral taken at 5 mg, as needed, max 2 times daily for glucocorticoid therapy from 08Dec2020 to an unspecified stop date; zopiclone (IMOVANE, formulation: film-coated tablet, strength: 7.5 mg) taken at 7.5 mg, daily for sleeplessness from 12Dec2019 to 04Apr2021; calcium, colecalciferol (CALCIUM & VITAMIN D, strength: 400 mg/19 ug) oral taken at 2 dose form, daily for calcium supplementation from 05Dec2019 to an unspecified stop date; fluticasone propionate (FLIXOTIDE, formulation: inhalation powder, strength: 250 ug) resp inhalation taken at 500 ug, daily for asthma prophylaxis from 05Dec2019 to an unspecified stop date; oxycodone hydrochloride (OXYCODON ACTAVIS, formulation: capsule, hard, strength: 5 mg) oral taken at 5 mg for pain from 25Dec2019 to an unspecified stop date and acetylcysteine (MUCOMYST, strength: 200 mg) oral taken at 200 mg, as needed, max 2 times daily for an unspecified indication from 03Mar2020 to an unspecified stop date. The patient previously received first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 09Mar2021 (Lot Number: EP9605; Expiration Date: 30Jun2021) as single dose for COVID-19 immunisation. The patient experienced type A aortic dissection (fatal) on 31Mar2021. The patient died on 01Apr2021. The reporter stated that the epicrisis did not state whether the case has been reported to the police and whether a forensic autopsy has been performed. There is no information regarding test results. The physician (reporter) does not suspect that there is a connection between the vaccine and the death, but wants to maintain his report since the patient passed away two days after the vaccination. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Type A aortic dissection


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