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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1675766

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Case Details

VAERS ID: 1675766 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-01
Onset:2021-09-06
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Mild adverse reaction to childhood vaccine at around age 4 or 5. According to mother Doctor discontinued next doses of that vacc
Other Medications: Lev-el Thrive shake Benadryl
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Shellfish, Sulfa drugs, Hydrocortisone, Codeine and Codeine derivatives, Cortisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day of injection brusing and pain at injection site and in muscle, flu like symptoms that went away after a few days. 16 days later injection sight has become swollen, red, sore, and hot to touch.


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