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From the 10/15/2021 release of VAERS data:

This is VAERS ID 944998



Case Details

VAERS ID: 944998 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-04
Onset:2021-01-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Headache, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-12
   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: Resident in skilled nursing facility. Please contact facility if needing all medications.
Current Illness:
Preexisting Conditions: Asthma, hypothyroidism, essential hypertension, atherosclerotic heart disease of native coronary artery, spinal stenosis, fibromyalgia, dementia. Please contact nursing facility for further needed information.
Allergies: Phenazopyridine, Demerol, Pyridium, Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 1/11/21 noted with headache, nausea/vomiting, severe melaise. On 1/12/21 resident expired.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=944998

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