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

This is VAERS ID 1758803

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Case Details

VAERS ID: 1758803 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-10-03
Onset:2021-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: Flu Vaccine
Other Medications: Omeprazole 40 PRN Nortrel Goody powder PRN
Current Illness: No
Preexisting Conditions: NA
Allergies: Flu shot Augmentin Adhesive on bandaids Ortho-evra
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient was c/o menstrual bleeding at 11 am today 10/04/21. She did state she was having pain at the injection site at 3 am today--10/04/21


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