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

This is VAERS ID 1408506



Case Details

VAERS ID: 1408506 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW3143 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood pressure systolic increased, Head injury, Heart rate, Joint injury, Oxygen saturation, Respiratory rate, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Faint (Previous faint when receiving vaccines as a young man - had not advised staff despite); Comments: Previous faint when recieving vaccines as a young man - had not advised staff despite being asked. Patient has not had symptoms associated with COVID-19 Not had a COVID-19 test Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:139/81 mmHg; Test Name: pulse; Result Unstructured Data: Test Result:77 bpm; Test Name: SpO2 on air; Test Result: 99 %; Test Name: respiration; Result Unstructured Data: Test Result:12 rpm
CDC Split Type: GBPFIZER INC2021640345

Write-up: blood pressure of 139/81 mmHg; Syncope; hit head and right knee; hit head and right knee; This is a spontaneous report from a contactable healthcare professional received from the regulatory authority report number is GB-MHRA-WEBCOVID-202106011927513670-G9DET, Safety report unique identifier GB-MHRA-ADR 25400941. A 33-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EW3143), via an unspecified route of administration on 01Jun2021 (at the age of 33 years old) as 1st dose, single dose for COVID-19 immunization. Medical history included syncope from an unknown date and unknown if ongoing. The patient had previous faint when receiving vaccines as a young man - had not advised staff despite. Patient has not had symptoms associated with COVID-19 and not had a COVID-19 test. Patient is not enrolled in clinical trial. The patient''s concomitant medications were not reported. The patient experienced syncope, hit head and right knee on 01Jun2021 and blood pressure of 139/81 mmHg on an unspecified date. It was reported that a few moments after sitting in waiting area post vaccination, the patient fainted. He hit head and right knee. The reporter assessed all events as non-serious. The patient underwent lab tests and procedures which included blood pressure: 139/81 mmHg, pulse (P): 77 bpm, SpO2 on air: 99 %, respiration (R): 12 rpm, all on unspecified dates. The outcome of the event syncope was recovered on 01Jun2021 while the outcome of all other events was unknown. No follow-up attempts are possible. No further information is expected.


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