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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1400874



Case Details

VAERS ID: 1400874 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Intensive care, Ruptured cerebral aneurysm, Surgery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: olmsrtn-amlepn hctz 40 -5-25 mg clonieine hcl 0.1 mg
Current Illness:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data: Surgery and in ICU for 12 days
CDC Split Type:

Write-up: 1 Ruptured brain aneurysm


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