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

This is VAERS ID 1339147

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Case Details

VAERS ID: 1339147 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-02
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6790 / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Cachexia, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical history/concurrent conditions: aseptic necrosis of head and neck of femur; coxarthrosis; decubitus; dementia; paranoid schizophrenia
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 with PCR test; Test Result: Negative
CDC Split Type: HUPFIZER INC2021560091

Write-up: cachexia associated with dementia; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB. Regulatory authority report number HU-OGYI-287321. A 68-year-old female patient received BNT162B2 (COMIRNATY, Solution for injection), via intramuscular on 02Mar2021 (Lot Number: EJ6790) as 0.3 ml, single for covid-19 immunization. Medical history included dementia, aseptic necrosis of head and neck of femur, coxarthrosis, paranoid schizophrenia, decubitus. The patient was in the hospital since 22Jan2021 in need of inpatient care. She was tested several times to COVID-19 with PCR test with negative results each time. She experienced no side effects from vaccination. The patient had decubitus. Her condition was deteriorating in general and she died on 21Mar2021. According to the reporter physician the patient died due to cachexia associated with dementia. An autopsy was performed and results was unknown. The outcome of the event was fatal. Sender Comment: The patient died due to cachexia associated with dementia 19 days after with COMIRNATY. The event and the vaccination are not related. The case is considered serious due to fatal outcome. No follow-up attempts possible. No further information expected.; Sender''s Comments: The 68-year-old female patient had medical history included dementia, aseptic necrosis of head and neck of femur, coxarthrosis, paranoid schizophrenia, and decubitus. The fatal event cachexia associated with dementia was not related to BNT162B2 (COMIRNATY), but was due to her pre-existing dementia and underlying diseases.; Reported Cause(s) of Death: cachexia associated with dementia; cachexia associated with dementia


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