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From the 5/7/2021 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 908675

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Case Details

VAERS ID: 908675 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Iowa  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Palatal oedema, Pharyngeal oedema, Tachycardia, Throat clearing, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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:
Current Illness:
Preexisting Conditions:
Allergies: IVP dye
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt received vaccine at 1210. At 1220 said her throat was feeling a little scratchy. She stated that it just felt like she "needed to clear her throat". NP was called to assist, evaluated and epinephrine 0.3ml IM was given. Benadryl 50mg and Zantac 40 mg was also given po. Pt was monitored, 9-1-1 was called and arrived in 10 minutes. Pt was sitting up, stating that it just "feels like my throat is thick". After EMS arrived and assessed pt, she began to ease her anxiety and stated she was feeling less tightness and felt better. Pt was observed, VSS. She denied going to the hospital stating she was feeling better so called for a ride home. EMS left and within 10 minutes she began to feel a tightening sensation in her upper chest, not in her throat this time. She said she felt the tightness again and the back of her throat was scratchy. NP evaluated, Epi 0.3ml IM was given again and 9-1-1 was called again. Upon arrival her vitals were stable, although tachycardic running 100-120 after the epi, but her breathing was not labored or difficult. EMS loaded pt and took to hospital for evaluation where she was monitored, received IV steroids for edema in the back of throat and uvula.

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