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

This is VAERS ID 1339148

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Case Details

VAERS ID: 1339148 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-02
Onset:2021-03-15
   Days after vaccination:13
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, Hyperventilation, Pneumonia, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-23
   Days after onset: 8
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: COVID-19 (in the hospital since 25Sep2020 initially with COVID-19 infection); Dementia; Dystopic kidney; Gastroesophageal reflux disease; Hypertension; Psoriasis
Allergies:
Diagnostic Lab Data:
CDC Split Type: HUPFIZER INC2021560092

Write-up: cachexia associated with pneumonia; cachexia associated with pneumonia; hyperventilation; somnolence; fever; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB. Regulatory authority report number HU-OGYI-287421. An 85-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 covid-19 (The patient was in the hospital since 25Sep2020 initially with COVID-19 infection. On 10Nov2020 she was transferred to the Nursing Department), dementia, hypertension, psoriasis, dystopic kidney and gastro-esophageal reflux disease. The patient''s concomitant medications were not reported. On 15Mar2021 the patient experienced hyperventilation, somnolence and fever due to pneumonia (hospitalization) not related to COVID-19. On 23Mar2021 the patient died due to cachexia associated with pneumonia. An autopsy was performed and results was unknow. The outcome of the event cachexia associated with pneumonia was fatal. Outcome for other events was unknown. Sender Comment: The patient died due to cachexia associated with pneumonia 21 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: Based on information provided, the events of hyperventilation, somnolence and fever due to pneumonia, cachexia associated with pneumonia more likely represent intercurrent illnesses which are unrelated to BNT162B2 (COMIRNATY). The case will be reassessed once more information become available.; Reported Cause(s) of Death: cachexia associated with pneumonia; cachexia associated with pneumonia


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