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

This is VAERS ID 1371474



Case Details

VAERS ID: 1371474 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Head injury
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Pt felt fine after vaccination and proceeded to waiting area and sat down to wait 15 minutes. A few minutes after she sat down she felt faint and fell out of her chair and bumped her forehead. We helped her back into the chair and held on to her. With her permission we had her sniff an ammonia inhalant and she said she felt a little better. She did not want us to call 911 or anybody at home. A pharmacy technician sat with her for about a half hour and a store manager filled out a report and said we will follow up with her later. She said she felt better and was able to leave on her own.


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