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From the 6/11/2021 release of VAERS data:

This is VAERS ID 904553

Case Details

VAERS ID: 904553 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Lip swelling, Paraesthesia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Symbicort, Spiriva
Current Illness: Pink eye
Preexisting Conditions: Asthma
Allergies: Soy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within a few minutes of taking the vaccine, my lower lip began swelling. I was moved to the emergency department of Hospital and monitored and treated for four hours. Then I was released. At around 1:30 p.m. I felt my skin singling and started having difficulty breathing. Since I was no longer at my work (Hospital) I went to the closest hospital. This reaction was much worse. My husband drove. My heart rate increased. I was released at around 6:30 pm

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