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

This is VAERS ID 1758649

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Case Details

VAERS ID: 1758649 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Ear discomfort, Mouth swelling, Pharyngeal swelling, Throat clearing, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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:
Other Medications: Levonorgestrel Ulipristal Ibuprofen Cyclobenzaprine
Current Illness: none indicated by pt
Preexisting Conditions: endometriosis scoliosis
Allergies: Ceftriaxone Dilaudid Naproxen Shell fish per pt
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt reported that "within 5 seconds" of receiving her 1st Pfizer (30155BA) vaccine she developed "itching to my throat" but denied any swelling to her mouth or throat. Pt ambulated with very steady gait to monitoring area and continued to speak full and clear sentences. Within 3 minutes of monitoring, pt began having persistent clearing of her throat and coughing", pt also indicated that she was having a burning sensation to her bilateral ears. Call out to ER MD and verbal orders obtained for Cetirizine 10mg po now. Pt was medicated and tolerated very well. Approximately 10 minutes post medication, pt reported "feeling much better" with her itching and burning decreasing. Lung sounds remained clear to auscultation bilaterally. Pt was -stridor or wheezing. No rash or swelling noted on physical exam. She remained calm and very cooperative. Within 30 minutes of monitoring pt, her symptoms continued to get better, minimizing to a 2-3/10 from initially a 6/10 itching to her throat. She was speaking full and very clear sentences with no other complaints upon discharge.


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