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

This is VAERS ID 1386841

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Case Details

VAERS ID:	1386841 (history)
Form:	Version 2.0
Age:	16.0
Sex:	Male
Location:	Georgia

Vaccinated:	2021-06-03
Onset:	2021-06-07
Days after vaccination:	4
Submitted:	0000-00-00
Entered:	2021-06-09

Vaccination / Manufacturer	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	- / UNK	AR / IM

Administered by: Other Purchased by: ?
Symptoms: Abdominal discomfort, Condition aggravated, Death, Headache
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-06-07
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: Adderall
Current Illness: Headache, upset stomach
Preexisting Conditions: ADHD
Allergies: NKDA
Diagnostic Lab Data: Autopsy pending
CDC Split Type:

Write-up: Prodrome of headache and gastric upset over 2 days following second dose. Then felt fine. Found the following day dead in bed. Autopsy pending

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