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

This is VAERS ID 1246822



Case Details

VAERS ID: 1246822 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-30
Onset:2021-04-19
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: vitamin D3, epiduo forte, synthroid
Current Illness: none
Preexisting Conditions: hypothyroidism, hx of tuberculosis
Allergies: none
Diagnostic Lab Data: 4/19/2021 PCR + COVID-19
CDC Split Type:

Write-up: Received 2nd dose of COVID vaccine on 1/30/2021. Patient had family member diagnosed with COVID-19 on 4/15/2021. Tested 4/19/2021 and positive for COVID-19 but no symptoms.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1246822


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