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

This is VAERS ID 1747102

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Case Details

VAERS ID: 1747102 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-09-13
Onset:2021-09-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF5357 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature, Feeling abnormal, Headache, Heart rate, Nausea, Oxygen saturation, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: Medical History/Concurrent Conditions: Duodenal stenosis (post-surgery)
Allergies:
Diagnostic Lab Data: Test Date: 20210913; Test Name: BP; Result Unstructured Data: Test Result:110/70; Comments: At 10:50; Test Date: 20210913; Test Name: BP; Result Unstructured Data: Test Result:105/64; Comments: At 10:57; Test Date: 20210913; Test Name: BP; Result Unstructured Data: Test Result:96/63; Comments: At 13:15; Test Date: 20210913; Test Name: body temperature; Result Unstructured Data: Test Result:36.3 Centigrade; Comments: Before vaccination; Test Date: 20210913; Test Name: body temperature; Result Unstructured Data: Test Result:36.3 Centigrade; Comments: At 10:57; Test Date: 20210913; Test Name: P; Result Unstructured Data: Test Result:70; Comments: At 10:50; Test Date: 20210913; Test Name: P; Result Unstructured Data: Test Result:64; Comments: At 10:57; Test Date: 20210913; Test Name: P; Result Unstructured Data: Test Result:89; Comments: At 13:15; Test Date: 20210913; Test Name: SaO2; Result Unstructured Data: Test Result:98(r.a) %; Comments: At 10:50; Test Date: 20210913; Test Name: SaO2; Result Unstructured Data: Test Result:98(r.a) %; Comments: At 10:57; Test Date: 20210913; Test Name: SaO2; Test Result: 96 %; Comments: At 13:15
CDC Split Type: JPPFIZER INC202101209685

Write-up: headache; Mild vomiting once the patient vomited small amount of gastric fluid; Queasy; feeling poorly; This is a spontaneous report from a contactable physician received from the Agency Regulatory Authority. Regulatory authority report number is v21126795. A 40-year and 6-month-old male patient received BNT162B2 (COMIRNATY), dose 1 via an unspecified route of administration on 13Sep2021 10:37 (Lot Number: FF5357; Expiration Date: 30Nov2021) (at age of 40-year and 6-month-old ) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included duodenal stenosis (post-surgery). The patient''s concomitant medications were not reported. Body temperature before vaccination was 36.3 degrees Centigrade. Event onset date was reported as 13Sep2021 at 10:50 (the day of vaccination). The course of the event was as follows: On 13Sep2021 at 10:37, vaccination was received. At 10:50, the patient experienced queasy and feeling poorly, BP 110/70, P 70, SaO2 98% (r.a) At 10:57, the patient experienced queasy and headache, BP 105/64, P 64, SaO2 98% (r.a) BT 36.3 degrees Centigrade. Mild vomiting once, the patient vomited small amount of gastric fluid, and drip infusion was performed. At 13:15, BP 96/63, SpO2 96%, P 89, the patient went home. The outcome of the events was resolved on 13Sep2021. The reporting physician classified the event as non-serious and assessed that the causality between the event and bnt162b2 as unassessable. There was no other possible cause of the event such as any other diseases. The reporting physician commented as follows: Unevaluable since the patient had similar symptoms after previous surgery relation. No follow-up attempts are needed. No further information is expected; Reporter''s Comments: Unevaluable since the patient had similar symptoms after previous surgery relation.


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