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

This is VAERS ID 1331307



Case Details

VAERS ID: 1331307 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Amoxicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Client complained of itchiness to throat, right arm, left foot, abdomen, and right temple. Denied any difficulty breath or shortness of breath. Able to drink water without difficulties. Offered Benadryl IM. Vital signs stable. B/P 110/56 HR 74 RR 18 O2 Sats 100%. No distress noted.


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