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

This is VAERS ID 1342766

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Case Details

VAERS ID: 1342766 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-04
Onset:2021-05-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature decreased, Hypotension, Hypoxia, Unresponsive to stimuli, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210507; Test Name: Body temperature; Result Unstructured Data: Test Result:decreased
CDC Split Type: AUPFIZER INC2021562782

Write-up: Body temperature decreased; Hypotension; Hypoxia; Unresponsive to stimuli; Wheezing; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory authority report number is 551850. An 81-year-old female patient received BNT162B2 (COMIRNATY), via an unspecified route of administration on 04May2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced body temperature decreased, hypotension, hypoxia, unresponsive to stimuli, wheezing, all on 07May2021 and caused death. The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Body temperature decreased; Hypotension; Hypoxia; Unresponsive to stimuli; Wheezing


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