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

This is VAERS ID 1398804



Case Details

VAERS ID: 1398804 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002621A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site rash, Pain in extremity, Pharyngeal swelling, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: zoloft 150mg hydrocodine 10 3 25 mg ropinirole 1mg
Current Illness:
Preexisting Conditions: asthma
Allergies: cherries naproxen ibprofen welbutrin chantix penicillin bactrum
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 hour after vax pain in left arm started along with inching and "dots" broke out around injection site all the way to the elbow, hand feels like its asleep all the time, throat feels swollen


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1398804


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