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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1368475



Case Details

VAERS ID: 1368475 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-06-01
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: None. Completed treatment with Augmentin 5/27/2021
Current Illness: Viral upper respiratory illness from 5/13/2021-5/27/2021
Preexisting Conditions:
Allergies: Pcn-Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: pruritic papular rash to arms, legs, and painful rash to left palm


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