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

This is VAERS ID 1462870

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Case Details

VAERS ID: 1462870 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: MYPFIZER INC2021830162

Write-up: Myocardial infarction; This is a spontaneous report from a contactable pharmacist received from the Regulatory Authority. A 42-year-old male patient started to receive bnt162b2 (COMIRNATY CONCENTRATE FOR DISPERSION FOR INJECTION) as DOSE NUMBER UNKNOWN, SINGLE via intramuscular on an unknown date for COVID-19 immunisation. Medical history and concomitant medication were not reported. On an unknown date, 14 day after the vaccination, the patient experienced Myocardial infarction. The outcome of reaction was reported as fatal / death to Myocardial infarction. Causality assessment of the reporter was possible to Myocardial infarction, Seriousness was Yes. No follow-up attempts are possible; information about batch/lot number cannot be obtained. ; Reported Cause(s) of Death: Myocardial infarction


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