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From the 5/14/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 1084036

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Case Details

VAERS ID: 1084036 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Mississippi  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Culture negative, Death, Dependence on respirator, Haemophagocytic lymphohistiocytosis, Laboratory test normal, Mechanical ventilation
SMQs:, Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Respiratory failure (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-15
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: type II diabetes
Diagnostic Lab Data: multiple tests and culture ruled out infections, etc. All led to HLH
CDC Split Type:

Write-up: Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)

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