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

This is VAERS ID 1715802

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Case Details

VAERS ID: 1715802 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F 3184 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: GSK Shingles vaccine-small shingles outbreak within 48 hours. Did not receive the 2nd shingles vaccine as a result. 65 years ol
Other Medications: Pulmacort and multi-vitamin
Current Illness: none
Preexisting Conditions: Reactive Airway Disease
Allergies: Ceclor, Codeine, other narcotics
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm muscle at injection site for about 3 days


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