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

This is VAERS ID 1396590



Case Details

VAERS ID: 1396590 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-05
Onset:2021-06-03
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID 03-JUN-21
CDC Split Type:

Write-up: PT TESTED POSITIVE FOR COVI-19 AFTER BIENG FULLY VACCINATED.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1396590


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