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

This is VAERS ID 1768213

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Case Details

VAERS ID: 1768213 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Metamucil, Whey protein, Orgain mega greens powder.
Current Illness: Tension Headaches
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain and swelling in right armpit (Axillary lymph nodes). Treatment: tyenol as directed for pain. Outcome: resolving on day 3 after day of injection.


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