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

This is VAERS ID 1242573

Government Disclaimer on use of this data

Case Details

VAERS ID:	1242573 (history)
Form:	Version 2.0
Age:	15.0
Sex:	Male
Location:	Colorado

Vaccinated:	2021-04-18
Onset:	2021-04-19
Days after vaccination:	1
Submitted:	0000-00-00
Entered:	2021-04-22

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

Administered by: Public Purchased by: ?
Symptoms: Cardiac failure, Death
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad), Noninfectious myocarditis/pericarditis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-04-20
Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vaccinated with Pfizer/Biontech, died 04/20/2021, 2 days after vaccination
Current Illness: No
Preexisting Conditions: No
Allergies: Nothing
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart failure

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1242573