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

This is VAERS ID 1330959



Case Details

VAERS ID: 1330959 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
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 EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Patient''s mother refused further care
CDC Split Type:

Write-up: About 5 minutes after shot, the patient''s mother alerted us to her daughter being unconscious. She was sitting in a chair slumped forward, we pushed her back in the chair. The patient was tensed up, sweaty, with labored breathing. She was assessed to not to be in respiratory distress and held so she wouldn''t slide out of the chair she was sitting in. She began to return to consciousness and pulse seemed relatively normal with breathing returning to normal after 3 minutes. Local EMS was activated. The patient was given cold water to hold on her neck and was alert. Local EMS assessed she was ok and the patient''s mother refused transport to the ED. The patient left on her own.


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