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

This is VAERS ID 1583478

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Case Details

VAERS ID: 1583478 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-31
Onset:2021-04-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fall, Lower respiratory tract infection, Oxygen saturation, Oxygen saturation decreased, Sepsis, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad)

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: Test Date: 20210412; Test Name: Oxygen saturation; Result Unstructured Data: Test Result: decreased.
CDC Split Type: AUPFIZER INC202101033747

Write-up: Fall; Lower respiratory tract infection; Oxygen saturation decreased; Sepsis; Syncope; Vomiting; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 598896. A 90-year-old female patient received bnt162b2 (COMIRNATY, Solution for injection), via an unspecified route of administration on 31Mar2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced fall (death) on 12Apr2021, lower respiratory tract infection (death) on 12Apr2021, oxygen saturation decreased (death) on 12Apr2021 , sepsis (death) on 12Apr2021 , syncope (death) on 12Apr2021 , vomiting (death) on 12Apr2021. The patient underwent lab tests and procedures which included oxygen saturation: decreased on 12Apr2021. The patient died in 2021. It was not reported if an autopsy was performed. The outcome of events was fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected; Reported Cause(s) of Death: Fall; Lower respiratory tract infection; Oxygen saturation decreased; Sepsis; Syncope; Vomiting


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