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

This is VAERS ID 1750396

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Case Details

VAERS ID: 1750396 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bently 20 mg oral tab Zofran 4 mg tablet
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data: 1525 Ambulance transported patient to ER
CDC Split Type:

Write-up: 1505 Patient complaint of dizziness, shortness of breath, and throat tightness after receiving pfizer vaccination. blood pressure taken 78/49 heart rate 56 1510 Benadryl 50 mg IV given times one. 1515 throat tightness, shortness of breath and dizziness still continues. Epipen 0.3 mg given times one in the left lateral thigh. blood pressure 71/38 heart rate 72. Placed patient in a trendelenburg position. 1515called 911 1517 blood pressure retaken 132/79 heart rate 73


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