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

This is VAERS ID 1437558



Case Details

VAERS ID: 1437558 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-29
Onset:2021-06-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT WAS SCREENED FOR COVID-19 VACCINE DOSE #2. PATIENT WAS ADMINISTERED VACCINE AT 9:03 AM AND ABOUT A MINUTE AFTER RECEIVING VACCINATION THE PATIENT PASSED OUT (BLACKED OUT) FOR A BRIEF SECOND AND THEN CAME BACK. PATIENT WAS TALKING NORMALLY AND HAD NO SOB. 911 WAS NOT CALLED, PATIENT THEN STAYED IN OBSERVATION AREA FOR 20 MINTUES AND AT THAT TIME PATIENT STATED THEY WERE FEELING BETTER. BOTH MOTHER AND DAUGTHER LEFT PHARMACY AFTER THAT. I ADVISED TO SEEK MEDICAL ATTENTION IF SYMTPOMS CAME BACK.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437558


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