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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1762130

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Case Details

VAERS ID: 1762130 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-02
Onset:2021-10-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Lymphoedema
SMQs:, Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (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: Atorvastatin 40mg; Multivitamin; L-Arginine 1000mg; Fish Oil 1500mg
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling in right armpit and fluid accumulation around/below armpit.


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