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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1329796

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Case Details

VAERS ID: 1329796 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-28
Onset:2021-04-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX3599 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-30
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Coronary disease; End stage COPD (COPD IV); Renal insufficiency
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021544661

Write-up: Unknown cause of death; This is a spontaneous report from a non-contactable physician downloaded from the Regulatory Authority-WEB DE-PEI-202100062331. A 75-year-old female patient received BNT162B2 (COMIRNATY, strength: 0.3ml), via an unspecified route of administration on 28Apr2021 (Batch/Lot Number: EX3599, at the age of 75-year-old) as single dose for covid-19 immunisation. Medical history included end stage chronic obstructive pulmonary disease (COPD) (COPD IV), coronary disease, renal insufficiency. The patient''s concomitant medications were not reported. On 30Apr2021, the patient experienced unknown cause of death. The patient died on 30Apr2021. An autopsy was not performed. The reporter''s assessment on the causal relationship between the suspect vaccine and the event was indeterminate. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death


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