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

This is VAERS ID 903506



Case Details

VAERS ID: 903506 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-17
Onset:2020-12-17
   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 EK5730 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenopia, Burning sensation, Chest discomfort, Chest pain, Chills, Dyspepsia, Ear discomfort, Erythema, Eye irritation, Full blood count normal, Hypoaesthesia, Metabolic function test normal, Nausea, Pain, Paraesthesia, Periorbital oedema, Piloerection, Swelling of eyelid, Throat clearing, Vertigo
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Vestibular disorders (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 30 mg tablet taken at 0600 am
Current Illness: Evening of 12/15 had sneezing and a mild runny nose took one dose of Sudafed and symptoms resolved Morning of 12/16 had mild PND and nasal congestion. After blowing nose had a few dry coughs. Took one dose of Claritin and symptoms resolved within one hour.
Preexisting Conditions: No
Allergies: Cipro Flagyl Codeine
Diagnostic Lab Data: 12/17/20: CBC 12/17/20: CMP
CDC Split Type:

Write-up: (1145) Left eyelid swelling 15 minutes after vaccination. (1155) b/l superior periorbital edema and erythema, b/l ear erythema and burning, and b/l hand tingling. (1200) Oral Benadryl 25 mg was given. (1230) symptoms improved and I was able to leave. While riding in the car on the way home started to have chills w/ goosebumps and nausea in short waves. Took an nap b/c my chills worsened and slept until 1630. Work up b/c of worsening chills, shivering, chest tightness, nausea, b/l hand numbness and tingling, right foot burning and stinging, and constant throat clearing b/c throat felt thick. Called the nurse on-call number provided in vaccine packet and was transferred to virtual care and report was given. Medical team advised me to go to the ED. (1900) Arrived at ED and temp was 101 and the chills, numbness, foot burning, and chest heaviness were worse and my eyes were burning and heavy. I was given oral Pepcid and an IV was started. After an IVP of Benadryl and Solu-Medrol I experienced severe burning starting in my head, neck, chest, and stomach. Then it felt like my veins were on fire all the way to my fingers and toes. This was followed by strong nausea w/o vomiting. I was then given IVP of Zofran and Ativan and NS drip. (1940-2020) Chills, burning around eyes, and vertigo continued other symptoms were improving .(2020) Provider returned and reported that labs were normal and I was probably having a reaction to the vaccine. (2035) Discharged from ED. Experienced chills, hand and foot numbness and tinging after discharge but was able to go to sleep.


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