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

This is VAERS ID 1443420



Case Details

VAERS ID: 1443420 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-26
Onset:2021-06-29
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Headache, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Nasopharyngeal swab testing for SARS CORONAVIRUS-2 RNA, V on 6/30/2021.
CDC Split Type:

Write-up: Sx onset 6/29/2021 with fever, chills, sore throat, headache & muscle aches. Tested positive for COVID-19 on 6/30/2021.


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