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

This is VAERS ID 1041955

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Case Details

VAERS ID: 1041955 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-11
Onset:2021-02-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Dysphagia, Purpura, Throat clearing
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The Over Age 65 flu vaccine at age 71. I was sick for three days afterward. Also twice when I was receiving regular allergy sho
Other Medications:
Current Illness:
Preexisting Conditions: epilepsy hypothyroid
Allergies: sulfa drugs, pets, environmental allergies, nylon, polyester
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty swallowing lasting one hour, had to continuously clear my throat of mucous, blood vessels burst under skin on both hands, gastrointestinal upset for three days.


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