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

This is VAERS ID 1417971



Case Details

VAERS ID: 1417971 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-14
Onset:2021-06-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast mass, Dysgeusia, Dysmenorrhoea, Menstruation irregular, Sleep disorder, Sleep terror
SMQs:, Taste and smell disorders (narrow), Fertility disorders (broad)

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: Asthma
Allergies: Beef
Diagnostic Lab Data: Spoke live with NP at my OB/GYN offoce to report adverse events on morning of 6- 22-21, particularly large painful breast lump and sudden menses after menopause of 1.5 years.
CDC Split Type:

Write-up: 1. painful, golfball size lump in right breast - not previously present ( 5-6 days after shot given in left arm). 2. Menstrual bleeding and strong menstrual cramping in lower back after 1.5 years into menopause (1 week after shot). 3. Sleep disturbances, waking multiple times per night, and awful nightmares / night terrors every night for past week following shot. 4. Metallic taste from 30 mins after shot, lasting up to 3 hours.


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