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

This is VAERS ID 997783



Case Details

VAERS ID: 997783 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-01
Onset:2021-02-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-03
   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: unknown
Current Illness: unknown
Preexisting Conditions: pt lived in long term care facility, unknown health conditions
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient passed away subsequent to receiving dose on 02/01. Staff does not have reason to believe vaccine was involved.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=997783

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