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

This is VAERS ID 1435190

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Case Details

VAERS ID: 1435190 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-06
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA5829 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Cachexia, Disease progression
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bone cancer; Cachexia; Hyperlipidaemia; Hypertension; Intestinal adenocarcinoma; Ischemic heart disease; Paralytic ileus; Prostate cancer; Pulmonary embolism; Stomach cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: HUPFIZER INC2021752049

Write-up: cancer cachexia; cancer cachexia; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB HU-OGYI-416021. This spontaneous, serious, medically confirmed case was reported on 31May2021 by a physician and concerns the occurrence of death after COMIRNATY injection for active immunization to prevent COVID-19. On 01Apr2021 the 75-years-old male patient received the first dose (batch number: EW2239) and on 06May2021 received the second dose of 0.3 ml COMIRNATY concentrate for dispersion for injection (tozinameran (COVID-19 mRNA Vaccine embedded in lipid nanoparticles), lot number: FA5829, expiry date: unknown, MAH: BioNTech Manufacturing Pfizer) intramuscularly in the left arm to prevent Covid-19. The patient was hospitalized on 12May2021 after experiencing nausea, vomiting and abdominal discomfort. The symptoms were assessed as paralytic ileus. Surgery was not performed due to the patients general condition as he had malign prostate cancer, stomach, intestinal adenocarcinoma and bone metastases. The patient received parenteral liquid supplement and comfort care. He passed away on 16May2021 17:15 due to cancer cachexia. Medical history included Prostate cancer, Paralytic ileus, hypertension, ischemic heart disease, Intestinal adenocarcinoma, Stomach cancer, Cachexia, Bone cancer, pulmonary embolism and hyperlipidemia. Past drugs included Taxotere (docetaxel) from Aug2016 to Dec2016 and Xtandi (enzalutamide). Concomitant drugs were not reported. Further information is not expected. Sender Comment: The reporter physician assessed the event of death as related to the patients primary diseases (cancer with metastases), therefore the causal relationship is unlikely between the suspected drug and the adverse event. The case is serious because the outcome was fatal. Further information is not expected. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Cachexia cancer; Cachexia cancer


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