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

This is VAERS ID 1330808

Case Details

VAERS ID: 1330808 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Eye movement disorder, Middle ear effusion, Skin warm, Syncope, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had a syncopal reaction: skin became hot and clammy, patient was dizzy, upon asking him to repeat a command or do a simple action (like wiggling fingers, lifting arm) he was not responding and his eyes were rolling to the back of his head and would not vocalize (when asked if ok, or what his symptoms were, or if he was having trouble breathing) at which time we called 911 since he was not responding verbally or physically. Had him sit, take off his mask, gave him water to sip, took BP (102/60), within 5 minutes he started to come back around, was able to follow command (wiggle fingers) vocalize that he could breathe fine, and felt that there was water behind his ears. His temperature to touch seemed to start to go back down, and once paramedics arrived they evaluated him and released him as "ok" within 10 minutes.

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