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

This is VAERS ID 903922

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Case Details

VAERS ID: 903922 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2020-12-18
Onset:2020-12-18
   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: Private       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Dysphonia, Dyspnoea, Pruritus, Rash, Throat tightness, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Singulair, Pepcid, Vit D
Current Illness: None
Preexisting Conditions: Migraines, allergic rhinitis
Allergies: Erenumab-aooe, Prednisone, Bees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complaint of rash,hives,difficulty breathing and swallowing, wheezing, throat tightness, hoarseness, itching and feeling light headed less than 10 minutes after receiving the vaccine. Patient received Benadryl 50mg IVP, Pepcid 20mg IVP, 0.3mg epi IM. EMS arrived and transported patient to ED. In ED, patient received second dose of 0.3mg epi IM. Patient monitored in ED for approximately 4 hours. Epi drip started and plan to admit patient for observation.


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