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

This is VAERS ID 1408713



Case Details

VAERS ID: 1408713 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-05-29
Onset:2021-06-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood urine present, Renal pain, SARS-CoV-2 test, Urinary tract infection, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), 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: Sertraline
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; decreased lactation.
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Test Result: No - Negative COVID-19 test; Test Name: Urine Sample; Result Unstructured Data: Test Result: Unknown Results.
CDC Split Type: GBPFIZER INC2021649096

Write-up: This is a spontaneous report from a contactable consumer, received via the regulatory authority (report number is GB-MHRA-WEBCOVID-202106021957381830-2GUMX). A 34-year-old female patient received the 1st dose of BNT162B2 (Pfizer-BioNTech COVID-19 vaccine, lot# not reported), via an unspecified route of administration, on May 29, 2021, single dose, for COVID-19 immunisation. Medical history included decreased lactation and anxiety. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in a clinical trial. Patient is not pregnant and not currently breastfeeding. Concomitant medication included sertraline taken for anxiety. On Jun 1, 2021, patient experienced kidney pain, urinary tract infection and blood in urine. Medically significant events. The patient underwent lab tests and procedures, which included COVID-19 virus test was No - Negative COVID-19 test and urine sample, with unknown results both on an unspecified date. Outcome of the urinary tract infection: recovering; while of the remaining events were unknown. The clinical course was reported as follows: Strong symptoms of UTI blood in urine and kidney pain. Patient has not tested positive for COVID-19 since the vaccination. No follow-up attempts are possible. Information about batch number cannot be obtained.


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