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

This is VAERS ID 1331293



Case Details

VAERS ID: 1331293 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
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 EW0185 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Pallor, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), 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: None
Current Illness: None
Preexisting Conditions: History of dizziness with vaccines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client received 1st COVID vaccine of Pfizer (Lot# EW0185 expiration 05/22/2021). Client has been sitting in vaccination chair for 5 minutes. RN provided supplemental nutrition and fluids. Client accepted fluids, but refused nutrition, states "I''m not hungry". At 1455, RN and PHN observed Client leaning forward with hand on his head. Client appeared to be pale. At 1456, RN and PHN assisted Client to gravity chair. Vital signs at this time are blood pressure 106/60, heart rate 78, oxygen saturation 97%. Client reports dizziness and blurred vision. Client continues to sit in gravity chair drinking fluids. Client is accompanied by his mother. Per Client''s mother, there is no past medical history, no known allergies, but history of dizziness with vaccines. At 1459, Client reports no blurred vision. At 1503 vital signs are blood pressure 112/62, heart rate 77, oxygen saturation 98. Client reports no blurred vision, no dizziness, no headache, no nausea, no chest pain. RN educated Client and mother about ED precautions and common adverse effects of COVID vaccine. AT 1503, vital signs are blood pressure 110/62, heart rate 75, oxygen saturation 99%. Client reports no blurred vision, no dizziness, no shortness of breath, no nausea, no chest pain, skin tone returns to appropriate coloration to ethnicity. At 1507, Client is able to stand up without complaints. Client left vaccination facility at 1508 with a steady gait accompanied by mother


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