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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1317357



Case Details

VAERS ID: 1317357 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-02-18
Onset:2021-05-02
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norco 5/325mg tabs, Albuterol MDI, apixiban 5mg BID, Probiotic daily, Vitamin D 5,000 units daily, duloxetine 90mg daily, escitalopram 10mg daily, Advair 1 puff BID, furosemide 80mg daily, gabapentin 1200mg BID, levothyroxine 88mcg daily, l
Current Illness: None recorded
Preexisting Conditions: Atrial fibrillation, cardiac pacemaker, COPD, Diastolic heart failure, hyperlipidemia, hypothyroidism, obstructive sleep apnea
Allergies: Codeine, lisinopril, pregabalin, simvastatin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pneumonia s/p Covid-19 resulting in hospitalization


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1317357


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