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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1024834

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Case Details

VAERS ID: 1024834 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-01-04
Onset:2021-02-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthropod bite, Diarrhoea, Erythema, Headache, Influenza like illness, Injection site reaction, Injection site swelling, Injection site warmth, Joint swelling, Muscle spasms, Myalgia, Pain, Pain in extremity, Peripheral swelling, Rash erythematous, Rash papular, Rash pruritic, Ultrasound scan, Vasculitis, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: abilify, lamictal, levothyroxine, vitamin C with elderberry, vitamin D
Current Illness: none
Preexisting Conditions: Bipolar I Disorder hypothyroidism
Allergies: vicodin/hydrocodone- causes vomitting
Diagnostic Lab Data: There were two ultrasounds conducted on my right leg to rule out blood clots. No blood lots. Diagnosis of vasculitis due to the vaccine.
CDC Split Type:

Write-up: 20 hours after first shot: vomiting, diarrhea and bad muscle aches/cramps and flu like symptoms. Head ache for 1 week. 8 days after injection the injection site swelled up like a bad bug bite and a red, hot, itchy, swollen rash spread down upper left arm almost down to the elbow. Took over two weeks to go away. **5 weeks post-vaccine, I woke up with leg pain the spread for one week down to my foot and up to my groin area (just in the leg and foot). My leg developed red marks up the inner thigh and inside of calf. My calf and ankle have now been severely swollen for 3 days and they are still swollen. The pain was so severe that it hurt to touch lightly and even worse with deeper touch and it hurt to walk. The pain has decreased but is still there 1 week after the reaction with my leg. My doctor diagnosed me vasculitis. I had autoimmune issues in high school (Graves'' Disease) so my Dr. wonders if I had some sort of autoimmune response to the vaccine. She said it could have been life threatening if I got the 2nd injection, which I should have gotten a couple weeks ago. I did not get the second shot.


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