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

This is VAERS ID 1391065



Case Details

VAERS ID: 1391065 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament 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: USPFIZER INC2021658999

Write-up: slight sore arm; This is a spontaneous report from a non-contactable consumer reported for a 12-year-old male patient who received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on 03Jun2021 (Batch/Lot number was not reported) as second dose single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient received the second dose of the Pfizer Covid vaccination on 03Jun2021 and experienced a slight sore arm the following morning (i.e., on 04Jun2021). The event took place after use of the product. The outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


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