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From the 11/26/2021 release of VAERS data:

This is VAERS ID 906717

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Case Details

VAERS ID: 906717 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Alaska  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Tachycardia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buproprion
Current Illness: None
Preexisting Conditions: None
Allergies: Dogs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Urticaria, tachycardia at 10 minutes post injection in left arm and neck Treated with oral cetirizine and montelukast. Resolved within 15 minutes of treatment. Discharged in good condition with PO diphenhydramine as needed.


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