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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1767479

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Case Details

VAERS ID: 1767479 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-27
Onset:2021-09-06
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Antibody test, Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; High cholesterol
Allergies:
Diagnostic Lab Data: Test Name: Antibody test to platelet factor IV; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101252879

Write-up: acute ischemic stroke; This is a spontaneous report from a contactable consumer (brother and care giver). A 77-years-old female patient received second dose of BNT162B2 (PFIZER BIONTECH COVID-19 VACCINE), via an unspecified route of administration administered in arm left on 27Aug2021 (at the age of 77-years-old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included high BP (blood pressure) and high cholesterol. The patient''s concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot number: EWO178) via an unspecified route of administration in left arm on 06Aug2021 at 13:20 (at the age of 77-year-old) as single dose for COVID-19 immunization and followed by Right hip really hurt/sore right hip (last couple weeks) on 08Aug2021. The patient concerned about her high blood pressure and high cholesterol. She contacted her doctor to get this second shot. Doctor said ok via phone appointment call. 9 days later on 06Sep2021, the patient had a stroke ''Acute Ischemic Stroke'' was hospitalize 2 days and reclosed. Follow up care was needed as she tried to recovered. The patient underwent lab test which included antibody test to platelet factor IV with unknown results. The outcome of the event was not recovered. The lot number for BNT162B2, was not provided and will be requested during follow up.


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