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

This is VAERS ID 1345168

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Case Details

VAERS ID: 1345168 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-05
Onset:2021-05-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX7389 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-12
   Days after onset: 0
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: Medical History/Concurrent Conditions: Carotid artery stenosis (Bilateral carotid stenosis since 2008, performed TEA left, right at last sten control); Multiple myeloma (Multiple myeloma since 2013, now in relapse phase with indication to restart chemo treatment); Parkinson''s disease (Parkinson''s disease since 2008)
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITPFIZER INC2021579844

Write-up: DEATH BY SUDDEN DEATH; This is a spontaneous report received from a contactable physician downloaded from the Regulatory Authority (RA)-WEB. The regulatory authority report number is IT-MINISAL02-729634. A 69-year-old male patient received BNT162B2 (COMIRNATY, Formulation: Solution for injection, Lot Number: EX7389, Expiration Date: 05May2021), via intramuscular on 05May2021 at 10:39 as a 2nd dose, single for COVID-19 immunisation. The patient''s medical history included parkinson''s disease since 2008 and unknown if ongoing, bilateral carotid stenosis since 2008, performed TEA left, right at last sten control and unknown if ongoing, multiple myeloma since (plasma cell myeloma) 2013, now in relapse phase with indication to restart chemo treatment and unknown if ongoing. The patient received first dose of BNT162B2 (COMIRNATY, Formulation: Solution for injection, Lot Number: EW2246, Expiration Date: 31Jul2021), via intramuscular in left deltoid on 14Apr2021 at 13:13 as a 1st dose, single for COVID-19 immunisation. The patient''s concomitant medications were not reported. The patient experienced death by sudden death on 12May2021. It was not reported if an autopsy was performed. Therapeutic measures were taken as a result of death by sudden death. The outcome of the event was fatal. Description: Actions taken (INTERVENTION 112 WITH ACTIVATION OF REANIMATION PROCEDURES) No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: DEATH BY SUDDEN DEATH


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