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

This is VAERS ID 1704616

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Case Details

VAERS ID: 1704616 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Erythema, Fatigue, Headache, Injection site pain, Malaise, Myalgia, Nausea, Pain in extremity, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg, rosuvastatin 10mg, hydrocodone 10-325
Current Illness:
Preexisting Conditions: Cervical disc disease, high blood pressure, sciatic nerve
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site pain,tiredness,headache,muscle pain,chills,joint pain,swelling,redness,nausea,feeling unwell,arm pain


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