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

This is VAERS ID 1377791



Case Details

VAERS ID: 1377791 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Nausea, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reported feeling nauseous and vomited a few minutes after receiving his second dose of pfizer. Pt looked pale and reported feeling lightheaded. Pt did not show any signs of respiratory distress: no swelling of the throat, face or mouth observed. Vital signs were within limit: BP 125/72, HR 60, RR 12 (at 3:45pm), BP 120/74, HR 62, RR 13 (at 3:45). Patient reported feeling better after vomiting. Observation nurse took vital signs, offered water and Gatorade. Pt left our site at 3:50 (Patient''s mother was driving).


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377791


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