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

This is VAERS ID 1019785

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Case Details

VAERS ID: 1019785 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-05
Onset:2021-01-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Menstrual disorder, Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D and Vitamin C
Current Illness: No
Preexisting Conditions: Fibroids
Allergies: No
Diagnostic Lab Data: Sonogram completed
CDC Split Type:

Write-up: 1 week after the first dose patient started to have her period. The period consisted of heavy clots and would go through 6-8 pads /day. Period lasted 3 weeks and went to see GYN and they prescribed Provera, which helped stop the bleeding.


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