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From the 1/14/2022 release of VAERS data:

This is VAERS ID 903518

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Case Details

VAERS ID: 903518 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Maine  
Vaccinated:2020-12-18
Onset:2020-12-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Nausea, Palpitations, Presyncope
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: bisoprolol
Current Illness: none
Preexisting Conditions: pre hypertension
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: nausea, lightheadedness, and palpitations that occurred ~10 minute post injection with decreased blood pressures c/w vasovagal response, improved over a few minutes


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