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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1418770



Case Details

VAERS ID: 1418770 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Hot flush, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBPFIZER INC2021663788

Write-up: Flush hot; Generally unwell; Headache; This is a spontaneous report from a contactable consumer received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106061044065090-1Z6HT, Safety Report Unique Identifier is GB-MHRA-ADR 25426993. An 85-year-old male patient received second dose of BNT162B2 (COVID-19 MRNA VACCINE BIONTECH), via an unspecified route of administration on 03Jun2021 as single dose for COVID-19 immunisation. Co-suspect drug SARS-COV-2 VIRUS was reported. Medical history included clinical trial participant. He has not had symptoms associated with COVID-19 and not had a COVID-19 test. The patient''s concomitant medications were not reported. The patient experienced flush hot, generally unwell, and headache on 04Jun2021. He has not tested positive for COVID-19 since having the vaccine. The patient was recovering from flush hot while outcome of other events was not recovered. Case was reported as serious by health authority (hospitalization). No follow-up attempts are needed, information about batch number cannot be obtained. No further information is expected.


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