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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1378303



Case Details

VAERS ID: 1378303 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Alopecia, Condition aggravated, Pruritus, Rash, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness:
Preexisting Conditions: Psoriasis
Allergies: Vicadine
Diagnostic Lab Data: Numerous trips to doctors. Numerous medications given. From the 1st of May through today.
CDC Split Type:

Write-up: Severe hair loss, severe rashes. Extreme scaling on scalp. Unbearable itching. Scalp flaking. Over 30% hair loss. Still losing.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1378303

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