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

This is VAERS ID 902766

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Case Details

VAERS ID: 902766 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-16
Onset:2020-12-16
   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 EH9899 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Cough, Immediate post-injection reaction, Vaccination site bruising, Vaccination site haemorrhage, Wheelchair user
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.


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