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

This is VAERS ID 1414801



Case Details

VAERS ID: 1414801 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC2473 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock, Aphonia, Asthma, Blood pressure increased, Blood pressure measurement, Cough, Electrocardiogram, Erythema, Fatigue, Headache, Human papilloma virus test, Magnetic resonance imaging, Muscle disorder, Paraesthesia, Swelling face, Swollen tongue
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CANDEBLO
Current Illness: Extrasystoles; Loss of smell
Preexisting Conditions: Medical History/Concurrent Conditions: Anaphylactic reaction to contrast agent (.); Asthma; COVID-19 (first symptoms on 28Oct2020 and was then also in hospital); Hypertension; Hypoacusis unilateral
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Blood pressure; Result Unstructured Data: Test Result:increased; Test Name: ECG; Result Unstructured Data: Test Result:unknown results; Test Name: HPV; Result Unstructured Data: Test Result:titer elevated since then; Test Name: MRI; Result Unstructured Data: Test Result:unknown results
CDC Split Type: ATPFIZER INC2021663424

Write-up: anaphylactic shock; 2 minutes after the vaccination tingling on the body; lost voice; tongue swollen; severe cough attack; lost tension of body; bronchies went close/ asthmatic flare; headache; red and swollen head; red and swollen head; blood pressure increased; very tired, especially in the afternoon; This is a spontaneous report from a contactable consumer. A 51 years old female patient received BNT162B2 (COMIRNATY; lot FC2473) on 04Jun2021 at 16:00 (at 51 years of age), as first single dose, in left upper arm, for COVID-19 immunisation. Medical history included asthma, COVID-19 from 28Oct2020 (first symptoms on 28Oct2020 and was then also in hospital with severe was on sick leave for a total of 3 months), she still had extrasystoles, still smelt nothing, could not hear on the right, she had an anaphylactic reaction to the contrast medium, hypertension. HPV titer elevated since then, since then also asthma. Concomitant medication included candesartan cilexetil (CANDEBLO; 8 mg) ongoing, for hypertension. On 04Jun2021 at 16:02 the patient experienced anaphylactic shock, tingling on the body, lost voice, tongue swollen, severe cough attack, lost tension of body, bronchies went close/ asthmatic flare, headache, red and swollen head, red and swollen head, blood pressure increased. She had an MRI contrast medium examination and had an anaphylactic reaction to the contrast medium which was the same as the reaction to Comirnaty. Now she was taken to hospital after the anaphylactic reaction. The solvent was suspected - the family doctor said no. Events clinical course include the following information: reaction after vaccination: after 2 minutes tingling in the whole body (just like after contrast medium), it got worse, then lost voice, tongue swollen and severe coughing, red and swollen head, then body tension gone, bronchial tubes closed/ asthma attack, her speech was impaired because the tongue felt weird, headache, blood pressure increased. All this had gone now, only the asthma was better but still not so good. The events required Emergency room. She got cortisone and acute antihistamine + infusions + ECG on the spot. She also received oxygen in the ambulance. In hospital: cortisone, infusions, oxygen with bronchodilator, then also adrenalin. Since Saturday (unspecified date) for a total of 5 days: desloratadin 5mg 1 tablet. Since the vaccination she still had a headache (that''s why she took Mexalen) and was very tired, especially in the afternoon. She had Epipen with her when she was vaccinated, but it was not used in the hospital, they used their own Epipen. She never fainted. The other events resolved on an unspecified date in Jun2021. No follow-up attempts possible. No further information expected.


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