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From the 1/14/2022 release of VAERS data:

This is VAERS ID 905757

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Case Details

VAERS ID: 905757 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-21
Onset:2020-12-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Lip pruritus, Lip swelling, Pruritus, Throat irritation, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Multivitamins, Vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Approximately 10 minutes after receiving vaccine, patient experienced itching of lips, tongue and throat. Itching also on neck and left arm. Some erythema around neck and upper chest. Lips swelling. Symptoms resolved within about 30 minutes of administration of oral diphenhydramine 50 mg and famotidine 20 mg.


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