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

This is VAERS ID 1415817



Case Details

VAERS ID: 1415817 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW3143 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Magnetic resonance imaging, Pain in extremity, SARS-CoV-2 test, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clinical trial participant; COVID-19; Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: bloods; Result Unstructured Data: Test Result:found nothing; Test Date: 20210604; Test Name: CT scans; Result Unstructured Data: Test Result:found nothing; Test Date: 20210604; Test Name: MRI; Result Unstructured Data: Test Result:found nothing; Test Date: 20210604; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC2021657492

Write-up: Seizures; fainted; felt terrible all of the 3rd june (day after vaccine) painful arm; This is a spontaneous report from a contactable consumer received from a regulatory authority. A 37-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW3143, expiry date not reported), via an unspecified route of administration on 02Jun2021 as first dose, single for covid-19 immunisation. Medical history included lactation decreased, clinical trial participant, had covid on an unspecified date. Patient has not had symptoms associated with COVID-19. Patient is not pregnant. Patient is not currently breastfeeding. The patient''s concomitant medications were not reported. The patient felt terrible all of the 03Jun2021 (day after vaccine) painful arm, similar feeling to when she had covid on an unspecified date. On 04Jun2021, patient went to the post office and fainted and had 2 seizures. Taken to hospital for tests - bloods, MRI and CT scans found nothing. Patient will not be having another vaccine. Tested negative for covid. The patient underwent lab tests and procedures which included COVID-19 virus test: negative (No - Negative COVID-19 test) on 04Jun2021. The patient recovered from seizures on 04Jun2021, while outcome of the remaining events was unknown. No follow-up attempts are possible. No further information is expected.


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