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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1349849

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Case Details

VAERS ID: 1349849 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-08
Onset:2021-01-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK3750 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis c/o chest tightness and "unable to breathe"-epi pen administered with immediate response. Narrative: c/o chest tightness. epi pen administered with immediate response. "I can breath now," pt. stated. Monitored, d/c''d to home/released from work.


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