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From the 1/7/2022 release of VAERS data:

This is VAERS ID 903035

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Case Details

VAERS ID: 903035 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-16
Onset:2020-12-16
   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 EK5700 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Corlanor 5mg, twice a day, Potassium 20 meq per day, HCTZ daily,
Current Illness: Renal Tubular Acidosis type 1.
Preexisting Conditions: Renal Tubular Acidosis Type 1 Hypocalemia Pacemaker
Allergies: Lidocaine (includes all caines), Contrast Dye
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Stayed for 15 minutes after the vaccine given and no reaction was noted and she left. States she got into her car about 20 minutes after the vaccine and started to "itch" all over and noted "red bumps" on the back of her neck. She had a flushed face by the time she arrived home but remained afebrile. Her itchiness is better but only concentrated on the back of her neck on 12/17/20 when she reported the reaction to Employee Health Services. She denied any further issues today.


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