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

This is VAERS ID 902839

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Case Details

VAERS ID: 902839 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Alaska  
Vaccinated:2020-12-16
Onset:2020-12-16
   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: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: None
Current Illness: None
Preexisting Conditions: Colitis secondary to possible Crohn''s disease, Inflammatory Polyarthropathy
Allergies: Adhesive Bandages, Bactrim abx
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Local pain and swelling of the injection site


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