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

This is VAERS ID 1038835

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Case Details

VAERS ID: 1038835 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-25
Onset:2021-02-12
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Haematuria, Petechiae, Platelet count decreased, Red blood cell sedimentation rate increased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ubidecarenon, Mecobalamin, Ferrous sulfate, Donepezil, Jardiance, Isosorbide Dinitrate, Lovastatin, Lisinopril/HCTZ, Metformin, Metoprolol Succinate, Cholecalciferol, Humalog, Levemir, Xyosted
Current Illness: CAD, Diabetes, HTN
Preexisting Conditions: As above
Allergies: No known allergies
Diagnostic Lab Data: PLT 2; ESR 29
CDC Split Type:

Write-up: Thrombocytopenia - admitted to the hospital with platelets of 2, hematuria, petechial rash


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