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From the 4/1/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 1089794

Case Details

VAERS ID: 1089794 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: School       Purchased by: ?
Symptoms: Blood glucose decreased, Chills, Dizziness, Heart rate decreased, Hyperhidrosis, Loss of consciousness, Pain, Pallor, Pyrexia, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: thyroid cancer, mild asthma
Diagnostic Lab Data: Heart rate was reported very low at 54bpm (my average is 85bpm) and low blood sugar
CDC Split Type:

Write-up: Within seconds of receiving the vaccine I began to feel slightly dizzy. By the time I walked across the room to the observation table I was feeling lightheaded. They sat me down, gave me water and a cookie, but about 2min after the injection the dizziness was so intense that I began to black out. I was unconscious for about 1-2min, then came to but my vision was still unclear. I was taken via wheelchair to the paramedics on the opposite end of the gymnasium, and at this point I was heavily perspiring and very pale but still coherent. I felt my vision and dizziness significantly improve after being able to lay down. I was transported to the hospital for observation but had much improved by the time I arrived. An EKG, bloodwork, and cardiac tests were recommended to discern possible underlying heart related conditions, but I declined because I already had a PAT for thyroid surgery scheduled the next day that would be running those same tests. This reaction was likely due to not having eaten for several hours prior to the vaccine. After about an hour I felt well enough to drive myself back home and dealt with mild aches and pains that evening, chills, and a low grade fever all of which resolved themselves by the next morning.

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