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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1690130

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Case Details

VAERS ID: 1690130 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chills, Migraine, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Nothing yet
CDC Split Type:

Write-up: Extreme chills, migraine, fever,and nausea. We gave her ibuprofen and have her under a heating blanket. She is sipping water.


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