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

This is VAERS ID 1376404



Case Details

VAERS ID: 1376404 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient received shot, waited 15 minutes, felt fine and left store. She called about an hour later (3:05pm) asking about tingling that she was experiencing on the side of her body that got the shot (arm, hand, leg) -I believe it was left side. Also a numbness on her mouth/lips. I advised pt to contact her primary which advised pt to go to urgent care. At urgent care she was seen and her symptoms subsided. I called pt at 8:45pm she stated that she was feeling better, but lip was still numb.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376404


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