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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1802763

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Case Details

VAERS ID: 1802763 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-06
Onset:2021-03-29
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Bone graft, Chemotherapy, Computerised tomogram, Jaw operation, Neoplasm skin, Oral neoplasm, Sepsis, Squamous cell carcinoma, Tumour excision
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal neoplasms (narrow), Osteonecrosis (broad), Skin malignant tumours (broad), Skin tumours of unspecified malignancy (narrow), Non-haematological malignant tumours (narrow), Non-haematological tumours of unspecified malignancy (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-13
   Days after onset: 198
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Graviola, Losartan, Anastrazole, Nortriptyline, Prilosec, Thyroid, Docusate
Current Illness: None
Preexisting Conditions: High blood pressure.
Allergies: Sulfa
Diagnostic Lab Data: CT scans, and biopsy''s
CDC Split Type:

Write-up: The patient had tumors growing in her mouth which was diagnosed as squamous cell cancer in May 2021. Patient had surgery May 17, 2021, they removed the tumor, took a graph from her leg and bone from the leg to reconstruct the jaw. By July 6, 2021, the tumor had grown back and was the size of an almond. Patient had chemo on 8/30/2021, became septic and was back in the hospital. Patient went home one week later, by this time the doctors said she was no longer a candidate for surgery and she had 2 tumors that broke out of the skin on her left side of her face. The tumors were 7 inches by 4 inches by 2.5 inches


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