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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1327685



Case Details

VAERS ID: 1327685 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: None listed
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received her vaccine and took a seat in the waiting area. After about 10 minutes she fainted and fell off her chair. Patient''s mom yelled after it happened and the pharmacist and rushed over to help. When the pharmacist got to the patient she was face down and when they turned her over she got up. She did not appear to have hit her head and regained consciousness quickly. 911 was called at the request of patient''s mother and the patient did not leave in the ambulance.


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