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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1245280



Case Details

VAERS ID: 1245280 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-19
Onset:2021-04-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Breast pain, Breast swelling, Chills, Decreased appetite, Diarrhoea, Erythema, Fatigue, Haematuria, Hyperhidrosis, Joint swelling, Menstruation normal, Mobility decreased, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Skin warm, Swelling, Weight decreased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, Ibuprofen, Tylenol, CBD
Current Illness: Kidney infection
Preexisting Conditions: Allergies, endometriosis, post tubal ligation syndrome symptoms
Allergies: Penicillin, Sulfa, Levaquin, Rye, Rice, Barley, Soy, milk, avocado, shellfish, crab, hazelnuts, bananas, mold, cat, dog, grasses, plantain, colcocobur, bee stings.
Diagnostic Lab Data: Test of uti/kidney infection showed blood in urine but I am menstruating so inconclusive.
CDC Split Type:

Write-up: It began with severe diarrhea and arm soreness, then came the extreme chills & fever (101F) and the worst body ache of my life. Then my arm and armpit and back and breast on the left side began to swell and swell and swell until I couldn''t keep my my arm down because it hurts my armpit but I also could not lift is because of the pain my shoulder and armpit and breast are all very swollen and red and hot. The fever and swelling are now working it''s way down my torso and hip and leg and foot all on the left side. On Wed 4/21 I went to Urgent Care and was tested for uti or kidney infection the result had blood in urine but as I am menstruating it was inconclusive. I had been give Ciprofloxacin to take Monday evening by a tele doc. Urgent Care ordered Prednisone 20mg 2 pills daily but the swelling keeps spreading. I have also been breaking out in sweats even just walking to the bathroom and am experiencing tiredness and severe loss of appetite and have lost 4 pound since 4/20 despite the swelling.


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