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

This is VAERS ID 1367864

Case Details

VAERS ID: 1367864 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Anxiety, Dizziness, Fall, Flushing, Hyperhidrosis, Mouth haemorrhage
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Stomach aches-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Pt started feeling lightheaded 1-2 minutes post-vaccination at 2:50PM and fell down on her backpack. Pt was conscious and mouth showed mild bleeding. RPh on duty had pt lie down on floor with both legs raised on chair and continuously monitored pt''s BP and pulse. Pt''s BPM was 109/73 and pulse was 88 at 3PM. Of note, pt reported PMH of vertigo x7 years and attributed her lightheadedness to anxiety. At 3:20PM, pt recovered and was able to stand and walk on her own.

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