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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1371666



Case Details

VAERS ID: 1371666 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Oxygen saturation decreased, Retching, Throat tightness, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 1st pfizer dose similar reaction but did not need Epi
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 10 minutes after injection patient experienced throat tightening and gagging with slight decrease in O2 (95%), given epi 0.3mg IM and 50mg benadryl IM with improvement ~1min after, improved O2 to 97%, transported via 911 to ED for further management


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