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From the 11/12/2021 release of VAERS data:

This is VAERS ID 902672

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Case Details

VAERS ID: 902672 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
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 EK5730 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Joint swelling, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alyacen birth control, minocycline, trintellix
Current Illness: none
Preexisting Conditions: NOS hypersomnia, anxiety, exercise induced asthma
Allergies: nickel, metals, environmental weeds grass trees mold mold spores dust dust mites cockroaches feathers
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Left arm swelling of forearm, old L wrist tattoo because raised and lifted out of skin approx 3 mm, whole arm was itching with several red dots; reaction resolved within 8 hours without intervention body wide itching persisting now


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