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

This is VAERS ID 1775792

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Case Details

VAERS ID: 1775792 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-10
Onset:2021-10-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ondansetron, cetirizine, lamictal, celexa, miralax, fludrocortisone, metoprolol, albuterol, flovent, prevacid
Current Illness:
Preexisting Conditions: POTS, GERD, asthma, allergies, depression
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right after she received her second dose, she started to feel really dizzy and said her head was pounding. It continued to get worse after 25 minutes. Her mother said this has happened before with other vaccines that it aggravates her POTS. Her mom said when this happens, she takes her to Children Hospital. She took her to the hospital after she left the pharmacy for treatment.


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