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From the 12/24/2020 release of VAERS data (an older release, current is 11/19/2021):

This is VAERS ID 904199

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Case Details

VAERS ID: 904199 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2020-12-19
Onset:2020-12-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEH9899 / 1 UN / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Hypoaesthesia oral, Lip swelling, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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: Ventolin inhaler EpiPen Fluoxetine Flonase Trazodone
Current Illness: None
Preexisting Conditions: Depression, Obesity, Anxiety
Allergies: Bee stings
Diagnostic Lab Data: Epinephrine IM, Pepcid, Benadryl, Prednisone, Acetaminophen, Toradol - for pain from Epi injection site
CDC Split Type:

Write-up: Scratchy throat, lip swelling and numbness


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201224&IDNUMBER=904199


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