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From the 11/26/2021 release of VAERS data:

This is VAERS ID 974489

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Case Details

VAERS ID: 974489 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-19
Onset:2021-01-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   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: Ipratropium and prednisone prescribed on 1/6/2021. Other medications include albuterol inhaler & nebulizer solution, calcium carbonate, cetirizine, cyclobenzaprine, fluticasone nasal spray, Advair HFA, home oxygen, guaifenesin, lidocaine 5
Current Illness: Asthma, COPD exacerbation.
Preexisting Conditions: Essential hypertension, dyslipidemia, allergic rhinitis, COPD, brain aneurysm, hiatal hernia, tobacco abuse, hyponatremia, normochromic, normocytic anemia, hx of MI, anxiety, intractable pain.
Allergies: Clarithromycin, cefaclor, ciprofloxacin, codeine, erythromycin, penicillins, tramadol, naproxen. All of these cause shortness of breath. Generic lisinopril-HCTZ caused severe headache and nausea. Statins cause joint pain and stiffness, couldn''t walk.
Diagnostic Lab Data: Medical Examiner does not believe this is related to vaccine.
CDC Split Type:

Write-up: No immediate symptoms. No symptoms ever reported. Patient was found dead in her home on 1/25/2021 and last seen on 1/24/2021. Neighbor called for welfare check because they had not seen her and she had not checked mailbox. No evidence of foul play.


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