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

This is VAERS ID 1459938

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Case Details

VAERS ID: 1459938 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-28
Onset:2021-05-24
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Blood test, Death, Hypophagia, Urine analysis, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-24
   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: acetaminophen, vit D3, vit B12, glimepiride, folic acid, ferrous sulfate, eliquis, Norco, Hyoscyamine sulfate, lasix, potassium chloride, oxybutynin, morphine, meropenem, vancomycin, mirapex, ativan, simvastatin
Current Illness: UTI
Preexisting Conditions: cellulitis RLE w/MRSA, Dysphagia, altered mental status, heart failure, lymphedema, chronic diarrhea, bladder CA, DVT RLE, leukemia, diabetes, hypertensive chronic kidney disease, parkinson''s, arthropathy, sleep apnea, restless legs symptoms
Allergies: lidocain/lidoderm
Diagnostic Lab Data: labs: urine, blood tests for WBCs
CDC Split Type:

Write-up: Participated in skilled therapy, continued visits w/oncologist, vaccine requested and administered, continued skilled therapy w/decrease in strength as what brought resident to SNF w/RLE cellulits w/MRSA, Vaccine series completed, continued skilled therapy, WBCs chronically elevated per oncologist as expected may occur w/cancer tx med for active leukemia. Continued decline overall w/decline in intake of food and fluids, hospice care initiated. Over the course of months, resident declined to bedrest w/expiration 5/24/21.


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