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

This is VAERS ID 1346628



Case Details

VAERS ID: 1346628 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Electrocardiogram, Electroencephalogram, Loss of consciousness, Syncope
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), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blisovi-Fe 24, Claritin
Current Illness: None
Preexisting Conditions: Concussion / post - concussion syndrome - just released from f/u care. Convergence insufficiency Asthenopia Atopic Dermatitis
Allergies: Zofran (Ondansetron) - Rash
Diagnostic Lab Data: ekg and eeg (pending results)
CDC Split Type:

Write-up: Pt was swimming and started to cough (felt swallowed water) and upon getting out of water - collapsed and lost consciousness for a few seconds


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1346628


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