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

This is VAERS ID 903380

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Case Details

VAERS ID: 903380 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-15
Onset:2020-12-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AK5730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ocular hyperaemia, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, mirtazapine, tamoxifen, olanzapine, levothyroxine, pantoprazole, lamotrigine, and Immune Response (OTC)
Current Illness: mild seasonal allergies
Preexisting Conditions: breast cancer survivor, hypothyroidism
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: hives all over body. with swelling.. Red eyes.


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