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

This is VAERS ID 1000711

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Case Details

VAERS ID: 1000711 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Florida  
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test abnormal, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-28
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rocaltrol, iron, folvite, neurontin, proamatine, zifaxan
Current Illness: chronic liver disease, hypoganadism, alcoholic cirrhosis, cont
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: multiple from prior records not related to vaccine
CDC Split Type:

Write-up: in addition to above, pt had the following diagnosis: portal HTN, abnormal blood chem, essential tremor, depressive disorder, abnormal glucose tolerance test, hyperlipidemia, hypothyroidism, insomnia, localized osteoarthrosis, calculus of kidney, pancytopenia, odule on liver, hepatocellular CA, hyotension, hypovolemia, hepatorenal syndrome additional meds: zoloft, aldactone, thiamine,demadex, ultram, kenalog, vitamins, bactroban ung

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