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

This is VAERS ID 1750251

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Case Details

VAERS ID: 1750251 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: PfizerBioNTech dose #2
Other Medications: Estriol cream
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever, chills, muscle aches, fatigue


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