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

This is VAERS ID 1470343



Case Details

VAERS ID: 1470343 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Cough, Dyspnoea, Headache, Muscular weakness, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dupixent
Current Illness: Mycobacterium Adium intracellulare. Eczema
Preexisting Conditions: MAI lung infection. Eczema
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Previous history covid in March 2021. After first shot reactivating of covid symptoms. Fatigue,fever,sever back pain,muscle aches,severe lethargy and headache. After second shot, shortness of breath,cough,headache,back pain and muscle weakness reactivated, cough, severe facial rash.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1470343


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