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

This is VAERS ID 1768713

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Case Details

VAERS ID: 1768713 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Wisconsin  
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 30145BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Pain, Pruritus, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), 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: Lutera
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pruritic rash on face and chest. Also weakness, fatigue, and body aches. Benadryl 50mg given orally.


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