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

This is VAERS ID 1377691



Case Details

VAERS ID: 1377691 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Feeling hot, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tri sprintec Montelukast 10mg Prozac 20mg Levothyroxine 50mg Metformin 500mg Clonidine 0.3mg (x2)
Current Illness:
Preexisting Conditions:
Allergies: Sulfa and anything with lavender
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives broken out on left arm. Red and very sore to the touch. Radiating heat. Since June 4th to present


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377691


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