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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1347003



Case Details

VAERS ID: 1347003 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-15 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Lymph node pain
SMQs:, Extravasation events (injections, infusions and implants) (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: multivitamin, echinacea, spirulina, vitamin D, elderberry
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain (hardness and burning sensation) in the left arm (injection site) in the lymph nodes in the back of the arm. Still occurring 4 days after receiving the injection.


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