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

This is VAERS ID 1415735



Case Details

VAERS ID: 1415735 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-05-31
Onset:2021-06-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Headache, Malaise, SARS-CoV-2 test, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), COVID-19 (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021657309

Write-up: dizziness; blurred vision; weakness in arms and legs, general weakness; feeling and been sick; Headache; This is a spontaneous report from a contactable consumer received from the Regulatory Agency (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202106041541367510-NKNR5. Safety Report Unique Identifier GB-MHRA-ADR 25421522. A 20-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 31May2021 as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. He has not had symptoms associated with COVID-19 and not enrolled in clinical trial. The patient experienced dizziness and blurred vision on an unspecified date; headache on 03Jun2021. Case narrative: headache, weakness in arms and legs, blurred vision, feeling and been sick, general weakness, and dizziness, all lasting so random 15-minute period 4 days after the vaccine. No relevant investigations or tests conducted. He has not tested positive for COVID-19 since having the vaccine. He underwent lab tests and procedures which included COVID-19 virus test: no - negative COVID-19 test on 03Jun2021. The patient recovered from all events on 03Jun2021. Case was reported as medically significant by health authority. No follow-up attempts are possible; information about lot/batch number cannot be requested.


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