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

This is VAERS ID 909000

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Case Details

VAERS ID: 909000 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-21
Onset:2020-12-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest X-ray, Electrocardiogram, Laboratory test
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: Hashimotos thyroiditis
Preexisting Conditions: As above
Allergies: NKMA
Diagnostic Lab Data: Urgent care on 12/23 Labs/ steroids/ IV fluids/ EKG/ CXR
CDC Split Type:

Write-up: Subsequent idiopathic anaphylaxis event 1 1/2 days later


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