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

This is VAERS ID 1240492



Case Details

VAERS ID: 1240492 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-20
Onset:2021-04-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Other Medications: Metformen, Glimiperide, atorvastatin, Bayer aspirin, vitamin D, prenatal vitamins, pro biotic,
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever 101.4, severe headache


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1240492


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