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

This is VAERS ID 903945

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Case Details

VAERS ID: 903945 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Alaska  
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 EH9899 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Immediate post-injection reaction, Laboratory test, Pruritus, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, lisinopril, dexilant,Motrin, victoza, insulin
Current Illness: Diabetes, hypertension, asthma
Preexisting Conditions: As above
Allergies: Latex, asprin, sulpha History of allergic reaction to hepatitis andtetnus(40 years ago), anaphylaxis to jellyfish sting Allergy to eggs, milk
Diagnostic Lab Data: 12/16/2020-no labs, IV Benadryl, Pepcid and decadron, I?m epinephrine sent home at 9 pm 12/17/2020- took epi pen at home in the morning back to ER given IV decadron, labs, ekg, chest X-ray done discharged home at 6pm
CDC Split Type: vsafe

Write-up: Itching started immediately, throat tightness SOB in about 10 minutes with hives on chest


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