From the 4/26/2024 release of VAERS data:

This is VAERS ID 920832

Government Disclaimer on use of this data

Case Details

VAERS ID:	920832 (history)
Form:	Version 2.0
Age:	104.0
Sex:	Female
Location:	New York

Vaccinated:	2020-12-30
Onset:	2021-01-01
Days after vaccination:	2
Submitted:	0000-00-00
Entered:	2021-01-05

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	EK5730 / 1	- / IM

Administered by: Unknown Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-04
Days after onset: 3
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:

Write-up: Vaccine 12/30/2020 Screening PCR done 12/31/2020 Symptoms 1/1/2021 COVID test result came back positive 1/2/2021 Deceased 1/4/2021

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=920832