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From the 1/14/2022 release of VAERS data:

This is VAERS ID 902948

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Case Details

VAERS ID: 902948 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2020-12-15
Onset:2020-12-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash pustular
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


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