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From the 1/14/2022 release of VAERS data:

This is VAERS ID 978529

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Case Details

VAERS ID: 978529 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2020-12-31
Onset:2021-01-15
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest X-ray, Computerised tomogram abdomen, Computerised tomogram thorax, Death
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix 20 mg daily, KCL ER 20 MEQ daily, Eliquis 2.5 mg twice daily, allopurinol 300 mg daily, Lyrica 50 mg daily, Metoprolol Succinate ER 50 mg daily, Amlodipine 5 mg daily, Pravstatin 20mg daily, Vit d3 25mcg daily
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: Bee Stings, Statins, Flecinide
Diagnostic Lab Data: Chest XR 1/15/21 CT chest/abdomen 1/15/21
CDC Split Type:

Write-up: Patient developed Covid pneumonia dx 1/15/21, patient expired


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