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

This is VAERS ID 1428917



Case Details

VAERS ID: 1428917 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis, Headache, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (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: None
Current Illness: None known
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 2d post receiving the second dose developed a nose bleed - lasted 10 minutes 2d post had headache all day 3d post started her menses (would not have been typically due at that time)


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