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

This is VAERS ID 907173

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Case Details

VAERS ID: 907173 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2020-12-22
Onset:2020-12-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Respiratory tract oedema, Stridor, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Eosinophilic pneumonia (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, Tylenol, Flexeril, Zyrtec, Norco, Singulair, Janumet, Turmeric, vitamin A
Current Illness:
Preexisting Conditions: Obesity, asthma
Allergies: Metoprolol, Biaxin, Lopressors, Robaxin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylaxis reaction with hives, stridor/airway edema, wheezing


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