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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1366592



Case Details

VAERS ID: 1366592 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site rash, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

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: Albuterol inhaler
Current Illness:
Preexisting Conditions: Hypoglycemia, asthma, PCOS
Allergies: All sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hardness at injection site, tenderness around entire shoulder, red splotchy rash, heat in rash, swelling. Started a couple of hours after vaccination


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