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

This is VAERS ID 1328224



Case Details

VAERS ID: 1328224 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
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 EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: has had a syncope event related to dilating eye drops at eye dr previously
Diagnostic Lab Data: paramedics took BP upon arrival, I did not obtain that information.
CDC Split Type:

Write-up: about 5 minutes after receiving injection, patient''s BP dropped. She was sitting when it happened and we rushed over to put feet up. She was non-responsive for about a minute and then started to come back for syncope episode. Water was provided until ambulance arrived to check on patient.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328224


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