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

This is VAERS ID 1760277

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Case Details

VAERS ID: 1760277 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site discolouration, Injection site erythema, Injection site oedema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Redness, edema, warm to the touch, itching, orange skin at injection site.


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