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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1366331



Case Details

VAERS ID: 1366331 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: While patient was sitting after the vaccination about couple hours, pt fell on the ground with her face down. pt was quickly laid on the ground with legs up on the chair. pt resumed alert and oriented after falling on the floor. After 15 minutes, pt felt better and started sitting on the chair and had some juice and coke. Then, pt still felt dizzy and nausea and decided to lay down again. After another 15 minutes, pt felt better and mom took her home. She was told to follow up if needed and watch for concussion.


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