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

This is VAERS ID 1442702



Case Details

VAERS ID: 1442702 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-15
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Dyspnoea, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021756167

Write-up: Pain; Diarrhea; difficulty breathing; headache; This is a spontaneous report from a contactable consumer or other non hcp (patient boyfriend). A 47-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number and Expiration Date not reported), via an unspecified route of administration on 15Jun2021 (at the age of 47-years-old) as dose number unknown, single for COVID-19 immunisation. The medical history and concomitant medications of the patient were not reported. The investigation assessment was not provided. The patient experienced pain, diarrhea, difficulty breathing and headache on an unspecified date in Jun2021. Reporter stated that he does not know if these are typical side effects, but the patient got the Covid-19 shot last Tuesday, 15Jun2021, and started getting side effects 3 days ago. The seriousness of the events was reported as non-serious. Reporter questioned if these are common side effects and was it normal for side effects to start up to 7 days after the vaccine and how long would they last. The report was not related to a study or program. The outcome of all the events was reported as unknown. Information on the lot/batch number has been requested.


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