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

This is VAERS ID 454143

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Case Details

VAERS ID: 454143 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2012-03-26
Onset:2012-04-01
   Days after vaccination:6
Submitted: 2012-04-20
   Days after onset:19
Entered: 2012-04-23
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1269AA / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-04-01
   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: Unknown
Current Illness: Sulfonamide allergy; Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1204USA02546

Write-up: Information has been received from a registered pharmacist concerning a 69 year old female patient with sulfa and amoxicillin allergies who on 26-MAR-2012, was vaccinated with a dose of ZOSTAVAX (Merck) (dose and route not provided) (lot # 671144/1269AA, expiration date 05-NOV-2012). The pharmacist informed that the patient died approximately on 02-APR-2012 "around 1 week after receiving the ZOSTAVAX (Merck)". The pharmacist indicated that no adverse reaction was reported or any physical symptoms other than the death and that the patient did not seek medical attention. The cause of death was not provided. A lot check has been initiated. Additional information is not expected.


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