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

This is VAERS ID 1350397



Case Details

VAERS ID: 1350397 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions: History of Cardiac catherization (angiogram) through right arm
Allergies:
Diagnostic Lab Data: Pulse: 91 bpm Respiration: 18 SPO2: 97% B/P 140/78 Exam: normal
CDC Split Type:

Write-up: AE: Patient started feeling itchy on the arms, redness and swelling in the right forearm seen 28 minutes after vaccination. Tx: n/a, water improved rash outcome: patient rash improved spontaneously without medication. patient was discharged home.


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