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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1240221



Case Details

VAERS ID: 1240221 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-21
Onset:2021-04-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (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:
Other Medications: IUD
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: My arm is very swollen and hard (and hot) below the injection site. It is extremely painful.


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