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

This is VAERS ID 1378254



Case Details

VAERS ID: 1378254 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
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 ER8735 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Dizziness, Full blood count, Laboratory test normal, Troponin normal
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Past medical hx includes stroke (during pregnancy), pre-eclampsia, Dysphagia, Diverticulosis, Diverticulitis, Chronic Diarrhea, abnormal Pap Smear. Past surgical hx hysterectomy, appendectomy.
Allergies: Pt w/ hx of allergy to ammonia (anaphylaxis, SOB), Pollen Extracts (anaphylaxis), Iodinated Contrast Media (Rash), Bleach (SOB - Subjective SOB if smell cleaning products).
Diagnostic Lab Data: In ED, Troponin Negative x1, Panel 7 WNL, Hemogram w/ diff WNL, Chest XR unremarkable.
CDC Split Type:

Write-up: Pt and pt''s daughter were in triage area, post-vaccination (1st dose PFIZER), c/o dizziness and non-radiating chest pressure located in midsection of chest, at approximately 7:50PM. On-site NP and clinic lead notified. Pt denied experiencing SOB or any other new/abnormal sx. Pt denied hx of smoking or taking BP meds. Pt was offered and given water. V/S @ 750PM: BP - 150/102, HR - 86, O2 - 98% V/S @ 758PM: BP - 167/106, HR - 90, O2 - 99% V/S @ 800PM: BP - 160/102, HR - 90, O2% - 99% Continued to monitor pt. Pt denied experiencing improvement to sxs. V/S @ 810PM: BP - 155/95, HR - 97 Pt denied experiencing any improvement to sxs. ED precautions given. Pt was encouraged to see ED. Pt agreed and requested to be transferred to ED via w/c. Pt was accompanied by NP, RN, and pt''s daughter to ED. Report given to ED nurse.


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