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

This is VAERS ID 1391485



Case Details

VAERS ID: 1391485 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: Patient became lightheaded and fainted in her chair in the observation room post injection. BP 103/71, HR 66, R 16, O2 sat 100%. Patient was given water and graham crackers. Continued to monitor patient; at 1003, BP 106/70, HR 73, R 16, O2 sat 100%. Patient stated that she was feeling better and was ready to leave. Patient was discharged to mother to go home.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1391485


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