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From the 5/14/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 1061637



Case Details

VAERS ID: 1061637 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2020-12-17
Onset:2021-01-03
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH98993121 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Eyelid pain, Neuralgia, Ophthalmic herpes zoster, Pruritus, Rash vesicular, Scab
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Glaucoma (broad), Periorbital and eyelid disorders (narrow), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: None
Preexisting Conditions: Mixed connective tissue disease
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1/1/21- Severe right side eye pain 1/3/21 - Appearance of vesicular rash with sever pain above right eyelid 1/3/21 - Diagnosed with Zoster Ophthalmicus of Right Eye at urgent care and initiated on Valacyclovir 1000 mg PO TID x 10 days 1/4/21 - Ganciclovir eye drops added to treatment course 1/10/21- Rash crusted and resolved but with severe neuropathic pain and itch 1/12/21 - Second dose of COVID vaccine received


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1061637

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