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

This is VAERS ID 902894

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Case Details

VAERS ID: 902894 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-16
Onset:2020-12-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypersensitivity, Lacrimation increased, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denied
Current Illness:
Preexisting Conditions:
Allergies: Prior reaction to "certain animals"
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Allergic reaction with facial swelling, eye tearing, "itchy" throat


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