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

This is VAERS ID 807348

Case Details

VAERS ID: 807348 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2019-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Diarrhoea, Fatigue, Feeling cold, Influenza like illness, Pneumonia
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2018-12-10
   Days after onset: 22
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: Comments: None
Diagnostic Lab Data:
CDC Split Type: GBSEQIRUS201902657

Write-up: Pneumonia; Feeling cold; Influenza like ilness; Fatigue; Diarrhoea; This is a spontaneous case, reported by other non-healthcare professional (consumer) to regulatory authority and initially retrieved on 18-Mar-2019 by Seqirus from regulatory authority (regulatory reference number: GB-MHRA-EYC 00195192), concerning an 86-year-old, elderly, female patient of weight: 50 kg and height: 157 cm. On 17-Nov-2018, the patient was administered Fluad (TIV) (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59, dose: 0.5 ml (reported as 1 DF), route of administration: parenteral, batch number: 254677, expiry date and anatomical location: not reported) for influenza immunization. On 18-Nov-2018, one day after vaccination, the patient developed diarrhoea, fatigue, some influenza like illness, pneumonia and was feeling cold. It was reported that, the patient didn''t go out of house between vaccination and her death, however one of the patient''s relative had visited her. On 10-Dec-2018, the patient died mysteriously due to pneumonia suddenly. It was unknown whether autopsy was performed or not. The patient had not recovered from the events feeling cold, flu-like symptoms, fatigue and diarrhoea. The reporter assessed the events as serious (fatal, life-threatening).; Reporter''s Comments: An 86-year-old female patient experienced symptoms of pneumonia and diarrhoea, 1 day after receipt of Fluad TIV. The patient died due to pneumonia, 22 days post vaccination. Considering the plausible temporal relationship between vaccination and reported event, plausible biological mechanism and lack of any underlying conditions or alternative more plausible causes, the company assessed the event diarrhoea as possibly related to suspect vaccine. Considering the onset latency and infectious etiology of the event pneumonia, the causal role of inactivated company suspect vaccine is ruled out. Hence, causality assessed as not related.; Reported Cause(s) of Death: Pneumonia

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