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

This is VAERS ID 1338262

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Case Details

VAERS ID: 1338262 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-03
Onset:2021-04-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6788 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-04
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bone metastases; Hypertension arterial; Type 2 diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210414; Test Name: febrile; Result Unstructured Data: Test Result:38 Centigrade; Test Date: 20210418; Test Name: Sars-cov-2 test; Test Result: Positive
CDC Split Type: FRPFIZER INC2021553633

Write-up: drug ineffective; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report from a contactable other hcp downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-RN20211289. A 73-years-old male patient received first dose of bnt162b2 (COMIRNATY), intramuscular on 13Feb2021 (Lot Number: EM0477) as 1st dose, single, second dose intramuscular on 03Apr2021 (Lot Number: EJ6788) as 2nd dose, single, for covid-19 immunisation. Medical history included ongoing Bone metastases, ongoing type 2 diabetes mellitus , ongoing Hypertension arterial , covid-19. The patient''s concomitant medications were not reported. Symptoms included flu syndrome (asthenia and febrile 38C) from 14Apr2021, as well as diarrhoea on 22Apr2021. Patient positive for Covid-19. COVID-19 test on 18Apr2021 was positive. On 04May2021, the patient was dead. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: COVID-19 confirmed by positive COVID-19 test; drug ineffective


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