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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1685234

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Case Details

VAERS ID: 1685234 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Contusion, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Peniccilin
Diagnostic Lab Data: Blood work, Iv, Medical exam
CDC Split Type:

Write-up: Head contusion, Fainting or Siezure


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1685234


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