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

This is VAERS ID 951087

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Case Details

VAERS ID: 951087 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-01-15
Onset:2021-01-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood pressure: 110/78 Temporal Temperature: 98.8 degrees F
CDC Split Type:

Write-up: 30 mins after IM injection: Left arm tingling 45 mins after IM injection: Left arm, Left shoulder, Left upper back tingling, Headache, chills, fatigue


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