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From the 4/30/2021 release of VAERS data:

This is VAERS ID 992977



Case Details

VAERS ID: 992977 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-20
Onset:2021-01-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Death
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pantoprazole, tramadol, duloxetine, vesicare
Current Illness: unsure
Preexisting Conditions: unsure
Allergies: cephalosporins, sulfa, penicillins, opiods,
Diagnostic Lab Data: unsure
CDC Split Type:

Write-up: spoke with patient husband on Saturday 1/23 and he said that she had been in the hospital. that she had had a stroke, the MD''s at the hospital told him that it was not contributed to the vaccine and that they were unsure even if the stroke had occurred prior to the vaccine or after. spoke with him again on 1-29 and he stated that she had passed away on 1/25/21


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=992977


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