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

This is VAERS ID 994788



Case Details

VAERS ID: 994788 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-25
Onset:2021-02-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-01
   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: Patient was a nursing home resident, please contact the facility for further scheduled medications.
Current Illness: Patient was a nursing home resident, please contact the facility for further diagnosis.
Preexisting Conditions: Patient was a nursing home resident, please contact the facility for further diagnosis.
Allergies: Ativan, Buspar, Cymbalta, Levaquin, Lyrica, Mirapex, Pristiq, Symbicort
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient death on 2/1/2021 at 4:55am at hospital.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=994788

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