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From the 4/30/2021 release of VAERS data:

This is VAERS ID 797713



Case Details

VAERS ID: 797713 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2018-12-08
Onset:2018-12-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2019-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UJ043AB / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breath sounds abnormal, Death, Dysphagia, Resuscitation, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2018-12-08
   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: risperidone; omeprazole; DEPAKOTE; calcium +D; ENSURE
Current Illness: Dysphagia; Bronchiectasis; Latent Tuberculosis; Pulmonary nodule; Mild dementia; Breast cancer; Bipolar disorder; Low weight
Preexisting Conditions: As above
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The following is history obtained from family after the event: The patient left the office, went for breakfast, developed difficulty swallowing in the restaurant and was making sounds in her chest when breathing, was driven home by family, was not answering her family verbally, then EMS was called and they could not revive her, she was sent to the ER.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=797713


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