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

This is VAERS ID 1440852



Case Details

VAERS ID: 1440852 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad), 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? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NO
Preexisting Conditions: NO
Allergies: UNKNOWN
Diagnostic Lab Data: VITALS, DIPHENHYDRAMINE 25 MG PO ADMINISTERED.
CDC Split Type:

Write-up: PATIENT EXPERIENCED REDNESS DOWN ENTIRE ARM, ITCHING AND BURNING IN FACE WITHIN 5 MINUTES OF INJECTION.


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