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

This is VAERS ID 1327986

Case Details

VAERS ID: 1327986 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: School       Purchased by: ?
Symptoms: Cold sweat, Hyperhidrosis, Immediate post-injection reaction, Pallor, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Vital signs taken, listed above, monitored 30 minutes
CDC Split Type:

Write-up: Received Vaccine, immediately became pale, clammy, diaphoretic, had near syncope episode, brought to mat to lie down, elevated feet on chair, AAO, no loc, no sob, ice pack to neck, front, back, and stomach, MD assessed surmised vaso vagal reaction occurred, patient came from a baseball game, Patients mom at the side, Vitals: 110/80, HR-60, regular and strong, respirations 12, regular nonlabored, 02 Sat 98%, After 10 minutes sat up and had water for hydration and snack for nourishment. Monitored for 30 minutes, provided reassurance, okay to exit with Mom after 30 minutes, provided education to mother regarding reaction

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