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From the 1/7/2022 release of VAERS data:

This is VAERS ID 905872

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Case Details

VAERS ID: 905872 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Arkansas  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Work       Purchased by: ?
Symptoms: Lip swelling, Pruritus, Rash, Rash erythematous, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (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: nk
Current Illness: nk
Preexisting Conditions: nk
Allergies: red wasps, some antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 minutes after vaccine, leg itching, checked for redness. Between 2200-2330 swelling of tongue, and lips swelling, administered epipen and prednisone. No 911 or did not notify her PCP. Today she feels fine but still has fine pink rash over body.

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