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

This is VAERS ID 1768722

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Case Details

VAERS ID: 1768722 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3529 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: atorvastatin prilosec multivitamin kril oil vitamin d 3 turmeric
Current Illness: none
Preexisting Conditions: high cholesterol type 2 diabetes fatty liver
Allergies: none
Diagnostic Lab Data: NONE
CDC Split Type: vsafe

Write-up: FEVER CHILLS BODY ACHE JOINT PAIN MUSCLE PAIN DIZZYNESS


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