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

This is VAERS ID 1330755



Case Details

VAERS ID: 1330755 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1085 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Post vaccination pt began s/s lightheaded ness, anxious and diaphoretic. RN and I transferred patient into cot, patient had syncopal episode of 2min, paramedics on site. Vital signs stable, patient states feeling, ? a lot better? after a few minutes. Patient and mother refuse going to the hospital. AMA was signed. Patient then transferred himself into wheelchair with minimal assistance. Patient waited in observation for 30min and left home with mom.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1330755


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