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From the 2/18/2021 release of VAERS data (an older release, current is 11/19/2021):

This is VAERS ID 1035850

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Case Details

VAERS ID: 1035850 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-04
Onset:2021-02-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 UN / IM

Administered by: Work       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Echocardiogram, Laboratory test, Magnetic resonance imaging, Neurological symptom, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-13
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair 250-50mcg Allegra-D 24 hour 180-240mg Amlodipine 2.5mg Buspirone 10mg Carvedilol 12.5mg Montelukast 10mg Prednisone 20mg Albuterol Zoloft 100mg Spiriva Nasacort AQ
Current Illness: Sinus Infection being treated with steroids and antibiotics
Preexisting Conditions: Asthma Allergies Chronic Sinus infections Depression History of heart attack
Allergies: Aspirin Erythromycin
Diagnostic Lab Data: Multiple CT scans, MRI''s, echo''s, labs
CDC Split Type:

Write-up: Patient woke up on the morning of 2/6 with symptoms of a stroke. Rushed to hospital where clot found in brain. Recovered from initial stroke but then had another major stroke on 2/8 and never recovered.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210218&IDNUMBER=1035850


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