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

This is VAERS ID 1440719



Case Details

VAERS ID: 1440719 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Presyncope, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Shakiness-Severe, Additional Details: Patient had vasovagal reaction 5 to 10 seconds after administration. Patient was seated and head was supported in chair by both administering RPh and Mom. Epi-pen was on hand but not given. Both APRN''s from minute clinic came into room to assist. Patient was lied down flat on the floor. Patient was slight hypotensive with 100 OSAT and pulse of 78. Patient lied down for 5 minutes, and then was able to sit up. She sat for another 20 minutes before she felt well enough to leave.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440719


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