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

This is VAERS ID 1434888



Case Details

VAERS ID: 1434888 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Nausea, SARS-CoV-2 test, Vaccination site bruising, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021709901

Write-up: Injection site bruising; Injection site pain; Nausea; This is a spontaneous report from a contactable consumer received from the Regulatory Authority; the Regulatory Authority report number is GB-MHRA-WEBCOVID-202106141814586390-HDSB4 and the Safety Report Unique Identifier is GB-MHRA-ADR 25472364. An 18-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on 04Jun2021 (batch/lot number was not reported) at 18 years old, as DOSE 1, SINGLE for COVID-19 immunization. The patient''s medical history included lactation decreased from an unknown date. The patient was not enrolled in clinical trial. Patient was not currently breastfeeding. Patient has not had symptoms associated with COVID-19. Concomitant medications were not reported. The patient experienced nausea on 04Jun2021, injection site pain on 05Jun2021, and injection site bruising on 06Jun2021. The patient recovered from the event nausea on 05Jun2021, from the event injection site pain on 08Jun2021, and from the event injection site bruising on 12Jun2021. The events were reported as medically significant. The patient has not tested positive for COVID-19 since having the vaccine; patient tested no - negative for COVID-19 virus test on an unspecified date. No follow-up attempts are possible; information about the batch/lot number cannot be obtained.


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