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

This is VAERS ID 1396445



Case Details

VAERS ID: 1396445 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-06-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (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: iron supplement, sertraline, zertec, vitamin d
Current Illness:
Preexisting Conditions:
Allergies: kiwi, squash, sweet potato, grass, oak, ragweed, mold
Diagnostic Lab Data: covid test (june 8th) -negative
CDC Split Type:

Write-up: headache, sore throat, cough, loss of taste and smell, congestion


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1396445


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