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

This is VAERS ID 1775508

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Case Details

VAERS ID: 1775508 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA173696 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: No daily medications. PRN use of Tylenol for HA.
Current Illness: N/A
Preexisting Conditions: Migraine HA
Allergies: Almonds, NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 28yo Male, presenting for 1st Pfizer vaccine, presented with fever and profound body aches, HA, and chills approx 10hrs after receiving 1st dose. Pt presented to medical clinic 24hrs later for eval and tx. No red flags on exam besides tachycardia and fever. Lung CTAB, and Heart/chest exam unremarkable. Pt treated with Tylenol after eval of sx. Pt would like this documented.


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