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

This is VAERS ID 1379529



Case Details

VAERS ID: 1379529 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Feeding disorder, Feeling abnormal, Headache, Insomnia, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: prozac magnesium vitamin b complex
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 6/4/21 at 9:20pm
CDC Split Type:

Write-up: symptoms: fever (up to 102) chills headache dizziness naesous body aches treatment: ibuprofen outcome: miserable, couldn?t sleep or eat and the fever wouldn?t break. the ibuprofen made the headache go away


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1379529


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