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From the 3/29/2024 release of VAERS data:

This is VAERS ID 1854668

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Case Details

VAERS ID: 1854668 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Wisconsin  
Vaccinated: 2021-09-07
Onset: 2021-09-01
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Death, Fatigue, Myalgia, Thrombosis
SMQs:, Rhabdomyolysis/myopathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-10
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole gabapentin celecoxib nivolumab was last given on 9/03/2021
Current Illness: Squamous cell lung cancer, Hx of radiation therapy, on antineoplastic chemotherapy, Esophagitis due to radiation,
Preexisting Conditions: Recurrent respiratory papillomatosis, Tracheal papillomatosis
Allergies: Pineapple
Diagnostic Lab Data: There was no autopsy ordered
CDC Split Type:

Write-up: Was very tired and had sore muscles on September 09. Found September 10, 5:25 am dead. There were excessive amounts of blood along with large blood clots that appear to have come vaginally.


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