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From the 5/7/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 972836

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Case Details

VAERS ID: 972836 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-20
Onset:2021-01-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Senior Living       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: 2021-01-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lorazepam, trazodone, levothyroxine , acetaminophen, multivitamin, senna
Current Illness: no
Preexisting Conditions: Alzheimer''s disease
Allergies: Levofloxacin, ACE inhibitors
Diagnostic Lab Data: no
CDC Split Type:

Write-up: sudden death


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=972836


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