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

This is VAERS ID 1386279



Case Details

VAERS ID: 1386279 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Eczema, Fatigue, Nausea, Psoriasis, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient went to MD 6/7/21 who diagnosed her with psoriasis/eczema. The patient wasn''t receptive to this diagnosis as they believe the COVID vaccine caused these reactions.
CDC Split Type:

Write-up: Patient developed chills, fatigue, nausea, and a generalized rash (inflammed and red).


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