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

This is VAERS ID 1347998

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Case Details

VAERS ID: 1347998 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW4815 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Breath sounds abnormal, Cardiac death, Dyspnoea
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-06
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOVICOL [MACROGOL 3350;POTASSIUM CHLORIDE;SODIUM BICARBONATE;SODIUM CHLORIDE]; FURESIS; CITALOPRAM; LYRICA; MONTELUKAST; PANADOL FORTE [PARACETAMOL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease; Atrial fibrillation; Coronary artery disease; Disability; Leg amputation; Loss of personal independence in daily activities; Lower limb ischaemia; Shortness of breath (Episodes of shortness of breath, swelling in the past while living in an assisted living facility); Swelling (Episodes of shortness of breath, swelling in the past while living in an assisted living facility)
Allergies:
Diagnostic Lab Data:
CDC Split Type: FIPFIZER INC2021572963

Write-up: Cardiac death; Coarse breath sounds; Dyspnoea; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority (RA)-WEB FI-FIMEA-20212550. An 89-year-old male patient received the second dose of BNT162B2 (COMIRNATY, lot number: EW4815 and expiration date not provided), via intramuscular, on 29Apr2021 (at the age of 89-year-old), at single dose, for COVID-19 immunization. Medical history included patient was multi-disabled, had been in 24-hour care for over a year, advanced Alzheimer''s disease, coronary artery disease, atrial fibrilation, acute lower limb ischaemia from Nov2019, left thigh amputation, restricted to hospital transfers. Patient had episodes of shortness of breath, swelling in the past while living in an assisted living facility. Concomitant medications included macrogol 3350, potassium chloride, sodium bicarbonate, sodium chloride (MOVICOL); furosemide (FURESIS); citalopram; pregabalin (LYRICA); montelukast; and paracetamol (PANADOL FORTE). Patient previously took first dose of BNT162B2 (COMIRNATY, lot number: EJ6134 and expiration date not provided), via unknown route of administration, on unknown date, at single dose, for COVID-19 immunization. The patient received vaccine on 29Apr2021, and later that day patient experienced cardiac death (death), coarse breath sounds (death), and dyspnoea (death). Patient had an increase in breathlessness, which was treated symptomatically (ventoline oral solution) and the dose of furosemide (FURESIS) was increased. The following day, as the symptoms persisted, an additional oral cortisone course was started, as there had been intermittent episodes of obstruction in the past, although the patient had no previous diagnosis of lung disease, but was no longer in a good enough overall health to warrant further investigation. With changes in medication, the patient''s condition improved and on 03May2021 the patient was already back to normal. On 05May2021 evening developed shortness of breath and wheezing, during the night patient received symptomatic medication, on 06May2021 morning patient exitus. The death was thought to be cardiac-related and a death certificate was issued. The situation has not yet been discussed with the infectious disease doctor, the coronary vaccine and death have a time link but no causal link was established, filing an incident report was nevertheless recommended. It was reported that it can''t be directly concluded that the drug harm was fatal, and on the other hand, the recovery from the possible harm remains a question mark. Therapeutic measures were taken as a result of events coarse breath sounds and dyspnoea. The outcome of the events were fatal. The patient died on 06May2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Cardiac death; coarse breath sounds; dyspnoea


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