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

This is VAERS ID 1339153

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Case Details

VAERS ID: 1339153 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Brain injury, Cardiopulmonary failure, Computerised tomogram, Congestive hepatopathy, Laboratory test, Oxygen saturation, SARS-CoV-2 test, Status epilepticus, Suspected COVID-19
SMQs:, Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Acute central respiratory depression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 1
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: NEUROTOP
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Epilepsy; Incontinence of urine; Meningioma; Vascular encephalopathy
Diagnostic Lab Data: Test Date: 20210407; Test Name: Cranial CT scan; Result Unstructured Data: Test Result:edema and possible white brain matter damage; Comments: abnormalities including edema and possible white brain matter damage; Test Date: 20210407; Test Name: Examinations; Result Unstructured Data: Test Result:congestive hepatopathy and circulatory decompensat; Comments: implied congestive hepatopathy and circulatory decompensation caused by cardiac insufficiency. Examinations not specified.; Test Date: 20210407; Test Name: oxygen saturation; Result Unstructured Data: Test Result:Low; Test Date: 20210408; Test Name: COVID-19 antigen test; Test Result: Negative ; Test Date: 20210408; Test Name: COVID-19 PCR test; Test Result: Negative
CDC Split Type: HUPFIZER INC2021559799

Write-up: Cardio-respiratory failure; Status epilepticus; congestive hepatopathy; Covid-like symptoms; possible white brain matter damage; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB, regulatory authority number HU-OGYI-289021. This is a report received from a regulatory authority. A 72-year-old female patient received first dose of bnt162b2 (COMIRNATY, solution for injection, Batch/Lot Number: EP2166, expiry date: unknown), intramuscularly on 18Mar2021 (at the age of 72-year-old) at 0.3 ml, single for active immunization to prevent COVID-19. Medical history included epilepsy, vascular encephalopathy, meningioma and Incontinence of urine, all from an unknown date and unknown if ongoing. Concomitant medication included carbamazepine (NEUROTOP) taken for epilepsy. The patient previously took carbamazepine (TIMONIL). The patient experienced cardio-respiratory failure and status epilepticus on 07Apr2021. This serious, medically confirmed report concerned the occurrence of status epilepticus and cardiorespiratory failure resulting in death after bnt162b2 injection. At the time of this report the patient was under care due to epilepsy. On 07Apr2021 the patient had a grand mal seizure which lasted for 30 minutes. After the seizure the patient was somnolent, had difficulty in breathing and her oxygen saturation was low on 07Apr2021. The patient was transferred to the hospital on 07Apr2021. Cranial CT scan on 07Apr2021 showed abnormalities including edema and possible white brain matter damage. The patient had Covid-like symptoms on 07Apr2021, but both antigen and PCR tests were negative on 08Apr2021. Examinations also implied congestive hepatopathy and circulatory decompensation caused by cardiac insufficiency on 07Apr2021. On 08Apr2021 at 15:15 the patient suddenly passed away due to cardiorespiratory failure. The outcome of events cardio-respiratory failure and status epilepticus was fatal, outcome of the other events was unknown. The patient died on 08Apr2021 at 15:15. It was not reported if an autopsy was performed. Sender Comment: The causal relationship cannot be assessed between the suspected drug and the adverse events because the patient passed away before additional examinations. TTO was 20 days. The case is considered serious because the outcome was fatal. Further information is not expected. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Cardio-respiratory failure; Status epilepticus

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