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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1366854



Case Details

VAERS ID: 1366854 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Syncope, Tinnitus, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt lightheaded, dizzy, popping and ringing in ears, blurred vision, and fainted for a few seconds. This occurred about 5-10 min following vaccination. Most likely a vasovagal syncope reaction. No history of allergic reactions nor syncope. After laying patient down and elevating his legs, he felt much better. Patient remained in this position for about 15 minutes. He then sat up, ate a snack, and drank water and was observed for an additional 15 minutes. Vitals were within normal range. Patient stated feeling"normal" and "fine" after this and he was able to go home without additional issues.


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