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

This is VAERS ID 971813



Case Details

VAERS ID: 971813 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-20
Onset:2021-01-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Death, Posture abnormal
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-21
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: A fib, type 2 diabetes, HTN, seizure disorder, CHF
Preexisting Conditions: A fib, type 2 diabetes, HTN, seizure disorder, CHF, Z alpha hydroxylase deficiency
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient received vaccine on 1/20/2121, later that night husband found her slumped in chair, called EMS and patient was taken to Hospital where she died on 1/21/2021


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=971813

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