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

This is VAERS ID 1772786

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Case Details

VAERS ID: 1772786 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-23
Onset:2021-10-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: no known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt received a covid vaccine on 9-23-21. Injection was at the right deltoid. Pt noted a small bump at his right bicep on 10-1-21. Unclear if it is related. Appears consistent with a small lymph node. Doubt clinically significant, but will monitor over time.


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