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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1420457

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Case Details

VAERS ID: 1420457 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Heart rate decreased, Hyperhidrosis, Mobility decreased, Nausea, Oropharyngeal discomfort, Presyncope
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: yes to IV dye
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis Narrative: After immunization felt nauseated and was diaphoretic, B/P 70/42, HR52, Fio2 100%, RR 12. IV 18g started left AC she appeared initially to be a vagal response. NS initiated and then she started complaining of throat issues and not being able to move arms. HR decreased to 40 and 1M epinepherine 0.3mg given left deltoid. Fluids NS rapid infused and 50mg of benadryl given IV. 02 at 10 1pm via none rebreather started. VS 126/67, 84, 20 100% 02 sat. Taken to the ER for further evaluation.

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