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

This is VAERS ID 993207



Case Details

VAERS ID: 993207 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-14
Onset:2021-01-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6795 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: 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: 2021-01-16
   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: STRESAM; FUROSEMIDE; THERALENE; L THYROXINE SERB
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiodepressive syndrome; Fall; Fracture multiple; Hip prosthesis insertion; Hip replacement (before Christmas); Hypertension arterial; Hypothyroidism; Osteoporosis; Shoulder fracture (around Sept to Oct2020)
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021067241

Write-up: Sudden death unexplained; This is a spontaneous report from contactable physician downloaded from the Regulatory Authority-WEB FR-AFSSAPS-NY20210068. A 96-year-old female patient received bnt162b2 (COMIRNATY) (lot number: EJ6795), intramuscular on 14Jan2021 08:50 at 0.3 mL, single for COVID-19 immunisation. Medical history included osteoporosis, Hypertension arterial, Hypothyroidism, Anxiodepressive syndrome, all from an unknown date and unknown if ongoing; Hip prosthesis insertion in Dec2020 and multiple fractures following repeated falls (left shoulder fracture around Sept to Oct2020 and hip replacement before Christmas). Concomitant medication included etifoxine hydrochloride (STRESAM) for Anxiodepressive syndrome, furosemide for Hypertension arterial, alimemazine tartrate (THERALENE) for Dementia and levothyroxine sodium (L THYROXINE SERB) for Hypothyroidism. No anticoagulation in progress at the time of vaccination. The vaccination was carried out on 14Jan2021 around 8:50 am and not in the afternoon. She had good immediate tolerance and no adverse effects on 15Jan2021 (while other facility patients had fever). On 16Jan2021, normal lunch at noon. The patient was seen at 4 p.m. having a snack. She was found dead at 5 p.m. in her chair. Death certificate mentioning sudden death unexplained. The patient died on 16Jan2021. An autopsy was not performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Sudden death unexplained


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