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From the 6/4/2021 release of VAERS data:

This is VAERS ID 907526



Case Details

VAERS ID: 907526 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-21
Onset:2020-12-21
   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 EK5730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site rash, Injection site swelling, Petechiae, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: to TDAP, Tetanus Toxoid and Influenza
Other Medications: takes bendaryl, Loratadine, & rescue inhaler PRN
Current Illness: No
Preexisting Conditions: hx sinusitis, asthma
Allergies: hx of allergy to influenza vaccine, TDAP & Tetanus Toxoid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per Vaccine recipient approximately 4-4 1/2 hours after receiving vaccine she noticed facial swelling in and around nose, to neck area, to R elbow and a petechial rash near R elbow. She immediately took Benadryl and Pepcid and then went to ER for further evaluation, where she was given a dose of Zyrtec and 5 day course of Prednisone. She left ER with no further complication.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907526


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