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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1689378

Case Details

VAERS ID: 1689378 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Death, Endotracheal intubation, Exposure to SARS-CoV-2, Extubation, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   Days after onset: 20
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ocrelizumab
Current Illness:
Preexisting Conditions: Multiple sclerosis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted on 8/10/2021 with acute respiratory failure secondary to COVID pneumonia. She was COVID positive on 7/22/2021 following a family gathering. She had been hospitalized for 3 days previously (8/4 - 8/7/2021) and seen in the ED on 8/8/2021. This current admission, she was intubated and required high dose dexamethasone. After 20 days, she was converted to comfort care and compassionate extubation was performed. She passed away comfortably soon after this.

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