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

This is VAERS ID 1367921



Case Details

VAERS ID: 1367921 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
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 EW0183 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Back pain, Headache, Pain, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medroxyprogesterone Intramuscular.
Current Illness: Pt denies
Preexisting Conditions: no
Allergies: Pt denies
Diagnostic Lab Data: none so far
CDC Split Type:

Write-up: Pt experienced weakness in body and blurry vision 5 minutes after 2nd dose of COVID-19 Pfizer. Pt woke up the next day to sharp lower back pain, body aches, HA and stomach discomfort.


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