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

This is VAERS ID 1475171



Case Details

VAERS ID: 1475171 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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:

Write-up: 14 yr old attendee departed after 15 minute observation period but returned at 27 minute mark (post vaccination) with nasal bleeding. Applied ice pack and bleeding stopped at 37 minute mark. Able to ambulate and departed again at 47 minute mark.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1475171


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