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From the 10/8/2021 release of VAERS data:

This is VAERS ID 985901



Case Details

VAERS ID: 985901 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-01-16
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK1768 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Glycosylated haemoglobin, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-01
   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: ASPIRIN [ACETYLSALICYLIC ACID]; ATORVASTATIN; LISINOPRIL; METFORMIN; NITRAZEPAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes mellitus inadequate control (Poorly controlled); Immunodeficiency (Has an illness or condition, not listed above, which reduces the immune response (e.g. immunodef...); Mental disorder; Neglect of personal appearance; Comments: Known poorly controlled diabetic. Poor attender at surgery. Routine bloods in April 2020 HbA1c 80. Very unkempt individual with concerns re self-neglect. Attendance for vaccination was first attendance at surgery in 10 months. Known mental illness, on long-term benzodiazepines Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Date: 202004; Test Name: hba1c; Result Unstructured Data: Test Result:80
CDC Split Type: GBPFIZER INC2021056670

Write-up: Sudden death unexplained; This is a spontaneous report from a contactable physician. This is a report received from Medicines and Healthcare products Regulatory Agency (MHRA). Regulatory authority report number was GB-MHRA-ADR 24619825 with Safety Report Unique Identifier of GB-MHRA-WEBCOVID-202101201100194950. An 88-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EK1768), via an unspecified route of administration on 16Jan2021 as a single dose for COVID-19 immunization. Medical history included immunodeficiency (an illness or condition which reduces the immune response), poorly controlled diabetic (HbA1c in Apr2020 was 80), mental illness, and unkempt individual with concerns of self-neglect. The patient had not had symptoms associated with COVID-19 and was not enrolled in the clinical trial. Concomitant medications included acetylsalicylic acid (ASPIRIN), atorvastatin (MANUFACTURER UNKNOWN), lisinopril (MANUFACTURER UNKNOWN), metformin (MANUFACTURER UNKNOWN), and nitrazepam (MANUFACTURER UNKNOWN). On an unknown date in Jan2021, the patient experienced sudden death unexplained. The clinical course was as follows: The patient came in for the vaccination and was not overtly unwell. He was observed for 15 minutes following the vaccination. On 20Jan2021, the patient was found dead by police and had been transferred to the coroner. It was not confirmed if an autopsy was going to be performed. At the time of reporting, there was no clear evidence as of yet to link the vaccination and death. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Sudden death unexplained


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