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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1697778



Case Details

VAERS ID: 1697778 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Swollen tongue, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 1745 vaccine administered. 1755 a bystander alerted staff of patient having a reaction. Staff summoned clinical staff to patient. Patient''s BP 148/70 HR 120, O2 saturation 99%. Tongue appeared slightly swollen. RLL slightly wheezy, otherwise clear throughout. Patient was able to communicate with staff and consumed 500 mL water independently. 1805 50 mg Benadryl administered orally. 1810 BP 130/70, HR 90, O2 saturation 99%. Lungs clear to auscultation throughout. At 1820 patient stated she felt better and felt well enough to go home with her daughter who was with patient. Prior to departure patient was educated about when to seek further care and when to utilize emergency services. At time of departure patient had no further questions or concerns.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1697778

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