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

This is VAERS ID 1785692

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Case Details

VAERS ID: 1785692 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-10-05
Onset:2021-10-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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: N/A
Current Illness: N/A
Preexisting Conditions: NONE KNOWN
Allergies: nkda
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient fainted shortly after 2nd pfizer dose and was unresponsive for a period of about 10-15 minutes, 911 was called, cold compress applied to back of neck, patient laid onto ground, BP was monitoring by vaccine administering nurse and reported as 98/58 and 98/52 for the 2 readings. EMTs arrived about 15mins later, by which time patient had just become responsive and was sitting upright, EMT performed their own evaluation/assessment of patient and was cleared by them, she sat in pharmacy waiting room for additional 15 minutes prior to leaving pharmacy.


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