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

This is VAERS ID 914994

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Case Details

VAERS ID:	914994 (history)
Form:	Version 2.0
Age:	90.0
Sex:	Female
Location:	Kentucky

Vaccinated:	2020-12-30
Onset:	2020-12-30
Days after vaccination:	0
Submitted:	0000-00-00
Entered:	2020-12-30

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	EL0142 / 1	AR / -

Administered by: Senior Living Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2020-12-30
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: not known
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt was a nursing home pt. pt received first dose of covid vaccine. pt was monitored for 15 minutes after getting shot. staff reported that pt was 15 days post covid. Pt passed away with in 90 minutes of getting vaccine

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