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

This is VAERS ID 1327778



Case Details

VAERS ID: 1327778 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Utah  
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 EW0185 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia, Feeling hot, Hyperhidrosis, Loss of consciousness, Malaise
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient came to the pharmacy to receive 1st dose of the Pfizer covid vaccine. About 5 minutes later patient felt unwell. According to her mom she passed out for about 5 seconds then jerked up and passed out again for a few seconds and woke up. Mom was unsure but thought it looked like a mini seizure. Both pharmacist was informed and checked on patient. Patient was hot and sweating but breathing was fine. Patient was coherent and could talk. Patient was given water. Blood pressure check was 102/69. Patient remained sitting with head over legs as that made her feel better. EMT arrived at the scene and took patient away on a stretcher for further observation.


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