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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1400945



Case Details

VAERS ID: 1400945 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002332 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: MINOXIDIL; VITAMIN D
Current Illness: Hair loss; Vitamin D deficiency
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased; Suspected COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Chills; felt feverish; Pain in arm; This regulatory authority case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Pain in arm) and CHILLS (Chills) in a 35-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002332) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased and Suspected COVID-19 from 27-Mar-2020 to 12-Apr-2020. Concurrent medical conditions included Hair loss since 01-Jan-2015 and Vitamin D deficiency since 01-Jan-2018. Concomitant products included MINOXIDIL from 01-Jan-2015 to an unknown date for Hair loss, VITAMIN D from 01-Jan-2018 to an unknown date for Vitamin D deficiency. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm). On 05-Jun-2021, the patient experienced CHILLS (Chills). 05-Jun-2021, the patient experienced PYREXIA (felt feverish). The patient was treated with PARACETAMOL for Pain in arm, Chills and Fever, at a dose of took 2 paracetamol 4 times a day to ease all reactions. On 06-Jun-2021, CHILLS (Chills) and PYREXIA (felt feverish) had resolved. At the time of the report, PAIN IN EXTREMITY (Pain in arm) was resolving. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Patient experienced pain in arm at the injection site and in neck started and got worse during the day of the vaccine. After 24 hours also had chills and felt feverish. She took two paracetamol four times a day to ease all reactions, which helped for a few hours. Patient has not tested positive for COVID-19 since having the vaccine. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding these events has been provided at this time. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding these events has been provided at this time. No further information is expected at this time.


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