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

This is VAERS ID 1378805

Case Details

VAERS ID: 1378805 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site pain, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Other Medications: Areds capsules 2 capsules daily Eye promise dry eye 2 capsules daily Blink gel eye drops two drops daily
Current Illness: Right eye ulcers
Preexisting Conditions: Dry eyes
Diagnostic Lab Data: No tests and no labs.
CDC Split Type:

Write-up: Headache and nausea at 3:00am on 04jun2021. No treatment given. Drank plenty of water throughout the day. Headache and nausea resolved approximately 8:00pm 04Jun2021. Left arm soreness at time of injection at injection site.

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