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

This is VAERS ID 1345169

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Case Details

VAERS ID: 1345169 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-04
Onset:2021-05-15
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX 7389 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-15
   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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: ITPFIZER INC2021579760

Write-up: death; This is a spontaneous report from a contactable physician downloaded from the regulatory authority, regulatory authority number IT-MINISAL02-730129. A 92-year-old female patient received first dose of BNT162B2 (COMIRNATY, Solution for injection, Batch/Lot Number: EX 7389, Expiration date not reported), via an unspecified route of administration on 04May2021 as a single dose for COVID-19 immunization. The patient past medical history and concomitant medication was not reported. It was reported that, the patient died on15May2021 but not due to the vaccine. Reporter assessed the causality of event as unrelated. The cause of death and autopsy was Unknown. Outcome of the event was was Fatal. Reporter''s comments: In my opinion this is an adverse event not related to the vaccine, with occasional concomitance only of a temporal and not causal type, i.e., not an adverse reaction but an adverse event not due to the vaccine. Sender''s comments: we asked the reporter for a clinical report. No follow-up attempts possible. No further information expected.; Reporter''s Comments: In my opinion this is an adverse event not related to the vaccine, with occasional concomitance only of a temporal and not causal type, i.e. not an adverse reaction but an adverse event not due to the vaccine.; Reported Cause(s) of Death: death


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