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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1411925



Case Details

VAERS ID: 1411925 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3661 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Dizziness, Heart rate
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Bradycardia; Result Unstructured Data: Test Result:35-40/min
CDC Split Type: JPPFIZER INC2021656065

Write-up: Bradycardia (35-40/min); swaying feeling; This is a spontaneous report from a contactable physician received from the Regulatory Authority (RA). Regulatory authority report number is v21111717.?? The patient was a 78-year-old male. On 03Jun2021 (the day of vaccination), the patient received?the first dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number FC3661, Expiration date 30Sep2021) via an unspecified route of administration as a single dose for COVID-19 immunization. The patient experienced symptoms on 03Jun2021. The course of the event was as follows: After the vaccination, the condition was observed, the patient said that there was swaying feeling. Although the subjective symptom improved, the patient said that there was bradycardia of 35-40/min. Requested emergency transportation and sent to (a hospital). The reporting physician classified the event as serious (At risk disability) and assessed that the causality between the event and bnt162b2 as unassessable.


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