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

This is VAERS ID 1761905

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Case Details

VAERS ID: 1761905 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Extra dose administered, Injection site pain, Neuralgia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Medication errors (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metroprol 25 bid, Lisinipril 10 qd, Atorvastatin 40 qd, Vitamens, D3, C, multivite ( over50), Calcium 600 with D,
Current Illness: None
Preexisting Conditions: None
Allergies: Brazil nuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 1 hour after, injection I experienced tachycardia - rate 120''s ( HR usually 60-68) and upper chest and throat pressure, not pain, but a definite felling of air hunger and pressure-felt as though I could not get enough air- the following day had extreme neuralgia (back, shoulder, and legs) plus the L upper deltoid was a 10/10 with movement - still experiencing discomfort today ( 5 days later). I had absolutely no reactions to the other 2 vaccines


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