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

This is VAERS ID 1767947

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Case Details

VAERS ID: 1767947 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 34135BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: trouble breathing after the nasal flu vaccine
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Nasal Flu immunization
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea and vomiting x3 days Body Aches Fever (low grade) Diarrhea x3 days


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