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

This is VAERS ID 1328766

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Case Details

VAERS ID: 1328766 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-20
Onset:2021-04-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER9480 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebral infarction
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-25
   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: FUROSEMIDE; TULOBUTEROL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPPFIZER INC2021538548

Write-up: Cerebral infarction; This is a spontaneous report from a contactable pharmacist received via a Pfizer sales representative. This pharmacist reported similar events for two patients. This is the first of the two reports. A 95-year-old female patient received BNT162B2 (COMIRNATY; Number: ER9480; Expiration Date: 31Jul2021), via an unspecified route of administration on 20Apr2021 as 1st dose, single for covid-19 immunization. Medical history included hypertension from an unknown date and unknown if ongoing. No information on family history was provided. Concomitant medications included furosemide (MANUFACTURER UNKNOWN), taken for an unspecified indication, start and stop date were not reported; tulobuterol (MANUFACTURER UNKNOWN) taken for an unspecified indication, start and stop date were not reported. The patient experienced cerebral infarction on 25Apr2021, which is serious as it lead to death. Details were as follows: On 25Apr2021 (5 days after vaccination), the patient died. The cause of death was noted as cerebral infarction. It was not reported if an autopsy was performed. The reporting pharmacist classified the event as serious sue to fatal outcome, and causality assessment between BNT162B2 and the event was reported as uncertain at present. The patient died on 25Apr2021. It was not reported if an autopsy was performed.; Sender''s Comments: A possible contributory effect of suspect BNT162B2 on reported event cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : JP-PFIZER INC-2021538915 same drug, reporter and event; different patient; Reported Cause(s) of Death: cerebral infarction


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