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

This is VAERS ID 1690103

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Case Details

VAERS ID:	1690103 (history)
Form:	Version 2.0
Age:	14.0
Sex:	Male
Location:	Foreign

Vaccinated:	2021-07-27
Onset:	2021-09-03
Days after vaccination:	38
Submitted:	0000-00-00
Entered:	2021-09-10

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	EW2246 / 2	- / -

Administered by: Other Purchased by: ?
Symptoms: Pulmonary oedema
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-09-03
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1690103