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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1241340



Case Details

VAERS ID: 1241340 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-16
Onset:2021-04-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Burning sensation, Chills, Ear discomfort, Headache, Nausea, Oropharyngeal pain, Pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Other Medications: Prozac 150 Lamictal 150 Seroquel 150 Klonipin 5 LASIK 40 Carvedilol 50 Lisinopril 5 Mobic 15 Metformin Myrbetriq Zofran D3 5000 Estrodial pill .1 3000 mg Tylenol
Current Illness: None
Preexisting Conditions: Cardiomyopathy Ptsd Anxiety depression
Allergies: Lactose intolerant Sensitive skin
Diagnostic Lab Data: 4/21/2021 emergency room at. They gave me fluids, Toradol, and zofran intravenously. The aches stopped but I still had a pounding headache when I left. As of right now I still do. I still have a very sore throat my ears have a lot of pressure behind them and am still nauseous. It feels like the worst flu I have EVER had
CDC Split Type:

Write-up: Extreme non stop aching. Nausea Temperature that ranged from 99 to 103 Chills Headache Very Sore throat Burning when taking a deep breath


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