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

This is VAERS ID 1452103



Case Details

VAERS ID: 1452103 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC6997 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Headache, Loss of consciousness, Muscle spasms, Presyncope, Syncope, Vertigo
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), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021752182

Write-up: loss of consciousness of very short duration; Syncope vasovagal; spasmophilia attack; headaches; vertigo; vasovagal reaction; This is a spontaneous report from a contactable physician downloaded from the WEB FR-AFSSAPS-2021074840. A 18-year-old male patient received bnt162b2 (COMIRNATY), intramuscular, administered in Deltoid Left on 04Jun2021 (Batch/Lot Number: FC6997) as DOSE 1, SINGLE at the age of 18 years old for COVID-19 immunisation. Medical history was reported as none. The patient''s concomitant medications were not reported. On 04Jun2021, 5 minutes after the vaccination, the patient had spasmophilia attack with clones/violent vagal discomfort, loss of consciousness of very short duration. Again the symptoms recurred with headaches and vertigo leading to prompting hospitalisation for monitoring. Summary of ongoing medical care: Hospitalisation in surveillance for 3 hours then discharge from hospital. Conclusion : Post-vaccination vasovagal reaction. The outcome of the events was recovered on unspecified date. No follow-up attempts possible. No further information expected.


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