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From the 1/14/2022 release of VAERS data:

This is VAERS ID 917439

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Case Details

VAERS ID: 917439 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Headache, Injection site rash, Pain, Pain in extremity
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2020 Flu shot, same symptoms and resolve time, without the rash at injection site.
Other Medications: Humalog, atorvastatin, sertraline
Current Illness:
Preexisting Conditions: Type one diabetes
Allergies: No known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Small red rash appeared next to the injection site, my arm was sore. I felt achey, had a headache and a slightly upset stomach. I felt better within 24 hours.


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