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

This is VAERS ID 1336455

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Case Details

VAERS ID: 1336455 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-12
Onset:2021-02-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Circulatory collapse, Intestinal infarction, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-23
   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:
Current Illness: Arterial hypertension; Coronary sclerosis; Gastritis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021553647

Write-up: Cardiovascular failure due to small bowel infarction in Bridenileus; Cardiovascular failure due to small bowel infarction in Bridenileus; General debility; Vomiting; This is a spontaneous report downloaded from the Regulatory Authority. A non-contactable physician reported that a 76-year-old female patient received second dose of (COMIRNATY, Batch/Lot number was not reported), via an unspecified route of administration at the age of 76-year-old on 12Feb2021 at 0.3ml single dose for COVID-19 immunisation. Medical history included ongoing arterial hypertension, ongoing coronary sclerosis, ongoing gastritis. The patient''s concomitant medications were not reported. The patient previously received first dose of bnt162b2 (COMIRNATY) on 22Jan2021 at 0.3ml single dose for COVID-19 immunisation. The patient experienced general debility and vomiting on 22Feb2021, cardiovascular failure due to small bowel infarction in Bridenileus on unspecified date. The outcome of events was fatal. The patient died on 23Feb2021. An autopsy was performed that revealed cardiovascular failure due to small bowel infarction in bridenileus. This report was reported as serious report. The drug related to all events. No follow-up attempts are possible; information about lot/batch number cannot be obtained; Reported Cause(s) of Death: Vomiting; General debility; Autopsy-determined Cause(s) of Death: Cardiovascular failure due to small bowel infarction in Bridenileus; Cardiovascular failure due to small bowel infarction in Bridenileus


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