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

This is VAERS ID 1411975



Case Details

VAERS ID: 1411975 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   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 - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Altered state of consciousness, Cough, Depressed level of consciousness, Pruritus, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPPFIZER INC2021658235

Write-up: Consciousness disturbed; Consciousness clouding; tachycardia; cough; itching; This is a spontaneous report from a contactable physician received from the Regulatory Authority. Regulatory authority report number is v21111814. The patient was a 49-year and 8-month-old female. Body temperature before vaccination was not provided. The patient had relevant medical history of Asthma. On 04Jun2021 around 10:00 (the day of vaccination), the patient received the first dose of bnt162b2 (COMIRNATY, Solution for injection, Lot number unknown, Expiration date unknown) via an unspecified route of administration as a single dose for COVID-19 immunization. Event terms were reported as itching, cough, tachycardia and Consciousness disturbed. Event onset date was reported as 04Jun2021. The course of the event was as follows: On 04Jun2021 at 10:05 (5 minutes after the vaccination), the patient experienced itching. On 04Jun2021 at 10:10 (10 minutes after the vaccination), the patient experienced cough. On 04Jun2021 at 10:15 (15 minutes after the vaccination), the patient experienced tachycardia and administered EPIPEN. On 04Jun2021 at 10:30 (30 minutes after the vaccination), the patient''s symptoms didn''t improved and administered EPIPEN, and experienced Consciousness clouding, so she was sent to this hospital. On 04Jun2021 (the same day after the vaccination), the outcome of the event was recovered. The reporting physician classified the event as non-serious and assessed that the event was related to bnt162b2. There was no other possible cause of the event such as any other diseases. The reporting physician commented as follows: I thought that it was the allergic reaction of COVID-19 vaccination. And not the Anaphylaxis.


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