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

This is VAERS ID 1241337



Case Details

VAERS ID: 1241337 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-14
Onset:2021-04-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site pruritus, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Lisinopril/HCTZ, Spironolactone, Prozac, Topamax, Benadryl, Trazadone
Current Illness: None
Preexisting Conditions: Hih blood pressure, depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm, headache, blood pressure on meds normally 110 over 65, a few hours after vaccine blood pressure 145 over 64, fatigue, all subsided after a few days, 1 week later hard lump at injection site about size of silver dollar that is red and itches.


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