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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1255569



Case Details

VAERS ID: 1255569 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
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: Test Date: 20210412; Test Name: COVID-19 virus test; Test Result: Positive
CDC Split Type: USPFIZER INC2021410140

Write-up: tested positive for Covid-19; COVID-19; This is a spontaneous report from a contactable consumer (patient) via Medical Information Team. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), first dose on an unspecified date and second dose on 09Apr2021, both via an unspecified route of administration at single doses for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient reported that she tested positive for COVID-19 on 12Apr2021 despite receiving second dose of the vaccine. Outcome of the events was unknown. Information on the lot/batch number has been requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021412463 same patient/drug, different doses/events


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