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

This is VAERS ID 1408712



Case Details

VAERS ID: 1408712 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
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 FA1027 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Vaccination site pain
SMQs:, COVID-19 (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: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021649152

Write-up: Injection site pain; This is a spontaneous report from a contactable consumer, received from theregulatory authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202106021956040820-EZNGK, Safety Report Unique Identifier GB-MHRA-ADR 25408044. A 21-year-old female patient received the first dose of BNT162B2 (Pfizer-BIONTECH COVID-19 Vaccine), via an unspecified route of administration on 01Jun2021 (at the age of 21-years-old) (Batch/Lot Number: FA1027) as a single dose for COVID-19 immunization. Medical history included suppressed lactation. The patient has not had symptoms associated with COVID-19, was not enrolled in a clinical trial, was not pregnant, and was not currently breastfeeding. The patient''s concomitant medications were not reported. The patient experienced injection site pain on 01Jun2021. The patient underwent lab tests and procedures which included sars-cov-2 test: no - negative covid-19 test on an unspecified date. The patient has not tested positive for COVID-19 since having the vaccine. Outcome of the event was not recovered. The case was reported as serious (medically significant). No follow-up attempts are possible. No further information is expected.


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