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

This is VAERS ID 1339519

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Case Details

VAERS ID: 1339519 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-10
Onset:2021-05-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW4811 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Altered state of consciousness, Body temperature, Brain herniation, Cerebral haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-13
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hepatic disease
Allergies:
Diagnostic Lab Data: Test Date: 20210510; Test Name: Body temperature; Result Unstructured Data: Test Result:36.8 Centigrade; Comments: before vaccination
CDC Split Type: JPPFIZER INC2021550660

Write-up: Extensive cerebral haemorrhage/Hypertensive cerebral haemorrhage; Brain herniation; Consciousness disturbed; This is a spontaneous report from a contactable pharmacist. This is a report received from the Regulatory Authority (RA). Regulatory authority report number is v21106552. A 95-year-old female patient received the first dose of the bnt162b2 (COMIRNATY; Lot Number: EW4811; Expiration Date: 31Jul2021), via an unspecified route of administration on 10May2021 at 14:30 at a single dose for covid-19 immunisation. Medical history included hepatic disease. The patient''s concomitant medications were not reported. On 12May2021 at 19:00, the patient experienced extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed, which required emergency room visit and hospitalization from 12May2021 to 13May2021. The clinical course was as follows: on 10May2021 around 14:30 (the day of vaccination), the patient received the first dose of BNT162b2. On 12May2021 at 19:00 (2 days after the vaccination), the patient experienced consciousness disturbed. On 12May2021 at 22:00 (2 days after the vaccination), the patient was groaning on the floor in her room and was unresponsive to calls; an ambulance was called and transported the patient to the reporting hospital. On 12May2021 (2 days after the vaccination), the patient was admitted to the hospital. Extensive cerebral haemorrhage mainly manifesting from the left thalamus over the left putamen was noted with a condition of brain herniation. The patient would only be attended on her deathbed as it was difficult to save her. On 13May2021 (3 days after the vaccination), the patient died and was discharged. The patient underwent lab tests and procedures which included body temperature: 36.8 degrees Centigrade on 10May2021 before vaccination. Therapeutic measures were taken as a result of extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed. The clinical outcome of the event was fatal. The patient died on 13May2021 due to extensive cerebral haemorrhage/hypertensive cerebral haemorrhage, brain herniation, and consciousness disturbed. It was not reported if an autopsy was performed. The reporting physician classified the events as serious (hospitalization) and assessed the causality between the events and BNT162b2 as unassessable. Other possible cause of the events such as any other diseases was hypertensive cerebral haemorrhage. No follow-up attempts needed. No further information expected, batch number/ lot number cannot be obtained.; Reported Cause(s) of Death: Consciousness disturbed; Brain herniation; Extensive cerebral haemorrhage/Hypertensive cerebral haemorrhage


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