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

This is VAERS ID 1262161



Case Details

VAERS ID: 1262161 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-04-19
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Herpes zoster, Neck pain, Post-acute COVID-19 syndrome, Skin weeping, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: yes
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: low white blood cell counts
CDC Split Type:

Write-up: sore shoulder , tired, light headed, neck pain, shingles on neck, oozing from ears, eyes, mouth, covid toes


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1262161


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