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From the 4/30/2021 release of VAERS data:

This is VAERS ID 903460



Case Details

VAERS ID: 903460 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2020-12-16
Onset:2020-12-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Ocular hyperaemia, Pain, Peripheral swelling, Rash, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone 25 mg daily Clonidine 0.1 mg for hot flashes Multivitamin Fish Oil Omeprazole 20 mg Calcium 600 mg with D5 20mcg
Current Illness: No
Preexisting Conditions: HTN Asthma (dormant)
Allergies: lactose
Diagnostic Lab Data: 25 mg of Benadryl prior to going to ER, IV: Benadryl, Decadron, Pepcid
CDC Split Type:

Write-up: Eye redness, pain, swollen Face swelling Bilateral arms and hands swelling Rash SOB


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=903460


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