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

This is VAERS ID 1758850

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Case Details

VAERS ID: 1758850 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-02
Onset:2021-10-03
   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 - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Muscle spasms, Pain
SMQs:, Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: MMR and Chicken pox vaccines resulted in fever and Rash
Other Medications: Guafasine, vitamin C, topical medicated shampoo
Current Illness:
Preexisting Conditions: ADD, Asthma, psoriasis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, cramps, fatigue, upset stomach


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