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

This is VAERS ID 1753274

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Case Details

VAERS ID: 1753274 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3188 / 3 LA / SYR

Administered by: Public       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: same soreness
Other Medications: Diabetes & Cholesterol meds
Current Illness: none
Preexisting Conditions: Diabetes & Cholesterol, Heart attack years ago
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness (slight) at injection site


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