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

This is VAERS ID 1371629



Case Details

VAERS ID: 1371629 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Redness at Injection Site-Medium, Systemic: it became red at the injection site a week after the vaccine-Medium, Additional Details: Pt said she was fine for 1 week then she npticed her arm where we did the injection is red around the injection site. she has some appointments and will take benadryl after so shes not sleepy she said. She said she didnt take anything for it. she sais she feels fine otherwise. no swelling or itching all over or difficulty breathing


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