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

This is VAERS ID 902667

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Case Details

VAERS ID: 902667 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2020-12-15
Onset:2020-12-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.


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