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

This is VAERS ID 1411990



Case Details

VAERS ID: 1411990 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
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 EY2173 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Body temperature, Computerised tomogram, Convulsions local, Dizziness, Heart rate
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Vestibular disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: blood pressure; Result Unstructured Data: Test Result:187/83; Test Name: body temperature; Result Unstructured Data: Test Result:38.0 Centigrade; Test Date: 20210604; Test Name: body temperature; Result Unstructured Data: Test Result:36.3 Centigrade; Comments: before vaccination; Test Name: CT; Result Unstructured Data: Test Result:no problem; Test Date: 20210604; Test Name: pulse rate; Result Unstructured Data: Test Result:65
CDC Split Type: JPPFIZER INC2021658783

Write-up: convulsion in the limbs; Light-headed feeling; blood pressure increased 187/83; This is a spontaneous report from a contactable physician received from the regulatory authority. Regulatory authority report number is v21111890. The patient was a 83-year-old male. Body temperature before vaccination was 36.3 degrees Centigrade on 04Jun2021. The patient received a pneumococcal vaccine and had a pyrexia of 38.0 degrees Centigrade on an unspecified date.On 04Jun2021 at 12:05 (the day of vaccination), the patient received the first dose of BNT162b2 (COMIRNATY, Solution for injection, Lot number EY2173, Expiration date 31Aug2021) via an unspecified route of administration as a single dose for COVID-19 immunization. The course of the event was as follows: Thirty minutes after the vaccination on 04Jun2021 (12:35), the patient experienced Light-headed feeling, so the patient took rest and look the condition even more. One hour later, (04Jun2021 at 13:05) the patient experienced convulsion in the limbs. It lasted for 15 minutes without any consciousness impairment. And blood pressure increased 187/83, pulse rate 65. Urgently deliveried to PRIVACY Hospital, no problem with CT. After the convulsion disappeared, the patient went home. The outcome of the events was recovered on 04Jun2021. 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: Because of the past history of pneumococcal vaccine caused pyrexia , the patient should pay attention to it in the future.


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