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From the 12/30/2020 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 902748

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Case Details

VAERS ID: 902748 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-15
Onset:2020-12-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PA156051 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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 , Wellbutrin , Bustar, trazodone , Lithium Carbonate ER , vistaril , Propranolol, MAXALT
Current Illness: COVID one week before
Preexisting Conditions: Bipolar Disorder
Allergies: NA
Diagnostic Lab Data: N/a
CDC Split Type: v-safe

Write-up: Chills, Body Ache, Fever


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201230&IDNUMBER=902748


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