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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1077644



Case Details

VAERS ID: 1077644 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-05
Onset:2021-03-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Body temperature increased, Chills, Feeling abnormal, Hallucination, visual, Headache, Insomnia, Pain in extremity, Toothache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms 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: Flu shot made mouth taste like metal for a day
Other Medications: Ortho tricyclen lo or sprinta (don?t remember birth control)
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: N/a Cheap wine gives me rash sometimes
Diagnostic Lab Data:
CDC Split Type:

Write-up: Visual Hallucinations (Hubble telescope stars and face in stars), inability to sleep, finger joint pain, toe pain, teeth pain, headache, chills and low body temp 97.1 Followed by 99.7 temp. It felt like I was dying and trapped in a nightmare or drug trip. (I have never done acid but I strongly believe that this is what a bad trip would have felt like)


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1077644

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