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

This is VAERS ID 1372075



Case Details

VAERS ID: 1372075 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature fluctuation, Feeling cold, Headache, Hot flush, Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Injection site swelling, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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: Pneumonia shot
Other Medications: Enbrel, cymbalta
Current Illness:
Preexisting Conditions: Fibromyalgia, psoriatic arthritis
Allergies: Penicillin, codeine, hydrocodone, nsaids, latex, bactrum
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, arm pain, injection site swelling, site redness, site hardness, site pain, site itching, site rash


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1372075


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