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

This is VAERS ID 908207

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Case Details

VAERS ID: 908207 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
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 - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactoid reaction, Blood pressure increased, Dysphagia, Electrocardiogram abnormal, Flushing, Oral discomfort, Sinus tachycardia, Tongue discomfort
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Dehydration (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: unknown
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: erythromycin
Diagnostic Lab Data: vitals, ECG
CDC Split Type:

Write-up: Patient experienced an anaphylactoid reaction within 20 mins of receiving the vaccine. Patient is a physician and attempted to self treat with diphenhydramine. After a short time of seemingly no resolution patient presented to the Emergency Department. Patient was examined. Elevated BP was noted (192/100), flushing, difficulty swallowing, and strange sensation of mouth and tongue were also present. An ECG was preformed and sinus tachycardia was observed at 105bpm. Patient received IM epinephrine and PO dexamethasone. Symptoms resolved. Patient was observed for 3-4 more hours.


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