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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1379747



Case Details

VAERS ID: 1379747 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Immediate post-injection reaction, Injection site pain, Wrong technique in product usage process
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs, fluroquinolones
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot was placed too high on arm. Shot was given too high/too deep. Experience immediate intense injection pain. Likely pierced bursa. Improper and poor technique. Reported to administrator of shot and emt on site. 3 days later having shoulder pain.


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