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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1421170



Case Details

VAERS ID: 1421170 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot last october, was violently ill for 4 days. Fever, sweating, chills, vomiting, dizzy.
Other Medications: levothyroxine 75 mcg tab---thyroid buPROPion SR 200 mg Sr12---weight loss Junel FE 24 1mg-20mcg (24)/75mg---weight loss Multi vitamin
Current Illness: none
Preexisting Conditions: RA
Allergies: All shellfish (use epi pen) EPINEPHrine 0.3mg/0.3mL Atin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sunday night: It started with hives on my left shoulder that progressed to my whole torso, treated with calamine and Benadryl. Monday after noon the hives came back under my armpits and down my arms, treated at work with Benadryl. Monday night the hives started again on my hips, lower back all the way to my knees, then they started on my upper chest to my ears and in my ears. Never reaching my face. Did not have any shortness of breath--the hives were extremely itchy and hot to the touch.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1421170


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