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

This is VAERS ID 1377763



Case Details

VAERS ID: 1377763 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
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 039B21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Procardia
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day after the second dose was injected, my upper left arm was red, warm, painful, and swollen. The swelling was beyond the injection site and involved the whole muscle. The adverse event began to clear three days after the second dose was received. The redness, pain, warmth, and swelling was significantly reduced.


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