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From the 11/12/2021 release of VAERS data:

This is VAERS ID 1380531

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Case Details

VAERS ID: 1380531 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW5279 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Death, Oxygen saturation, Oxygen saturation decreased
SMQs:, Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-24
   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: KVENTIAX; CONCOR COR; LASIX [FUROSEMIDE SODIUM]; LEKADOL; PLIVIT D3; PANTOPRAZOL TEVA; TRAJENTA; ANALGIN [METAMIZOLE SODIUM MONOHYDRATE]
Current Illness: Illness; Immobile; Oxygen therapy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210423; Test Name: Body temperature; Result Unstructured Data: Test Result:38.4 Centigrade; Test Date: 20210424; Test Name: Oxygen saturation; Test Result: 77 %
CDC Split Type: SIPFIZER INC2021630085

Write-up: Death; Oxygen saturation decreased; Body temperature increased 38,4?C; This is a spontaneous report from a contactable physician via Regulatory Authority, downloaded from the Regulatory Authority-WEB (regulatory authority number SI-JAZMP-NCPHV-2021SI0612_0612). A 90-year-old male patient received the second dose of bnt162b2 (COMIRNATY) intramuscular on 23Apr2021 11:00 (at the age of 90-year-old) (Batch/Lot Number: EW5279; Expiration Date: 31Jul2021) as single dose for COVID-19 immunisation. Relevant medical history included ongoing immobile, ongoing chronically ill and ongoing permanent oxygen therapy at home. Concomitant medications included quetiapine fumarate (KVENTIAX) taken for an unspecified indication from 13Mar2021 to an unspecified stop date; bisoprolol fumarate (CONCOR COR) taken for an unspecified indication from 17Mar2021 to an unspecified stop date; furosemide sodium (LASIX) taken for an unspecified indication from 17Mar2021 to an unspecified stop date; paracetamol (LEKADOL) taken for an unspecified indication from 17Mar2021 to an unspecified stop date; colecalciferol (PLIVIT D3) taken for an unspecified indication from 17Mar2021 to an unspecified stop date; pantoprazole sodium sesquihydrate (PANTOPRAZOL TEVA) taken for an unspecified indication from 27Mar2021 to an unspecified stop date; linagliptin (TRAJENTA) taken for an unspecified indication from 17Mar2021 to an unspecified stop date; metamizole sodium monohydrate (ANALGIN) taken for an unspecified indication from 26Mar2021 to an unspecified stop date. On 23Apr2021 at 3pm, the patient experienced increased body temperature 38.4?C (lasted one day) and had an increased need for oxygen (already on permanent oxygen therapy at home). On 24Apr2021 at 6 p.m., oxygen saturation dropped to 77%, and despite the arrival of emergency general medical care, the patient died at 7:05 p.m. The patient was not newly ill for at least one week before vaccination. The patient was immobile, chronically ill and on permanent oxygen therapy at home. The cause of death was unknown. It was not reported if an autopsy was performed. This case report was assessed as medically significant. No additional data arrived in the initial case report. Additional information was requested. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: death


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