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

This is VAERS ID 1745708

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Case Details

VAERS ID: 1745708 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Muscular weakness, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), 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: COVID-19 Pfizer second dose. Adverse events were the same as described above.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 09/29/2021 2:00 AM: Onset of fatigue, muscle weakness, general aches and pains, chills, headache, general feeling of weakness, and fever.


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