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

This is VAERS ID 1404118



Case Details

VAERS ID: 1404118 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT 3002332 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse drug reaction, Lymphadenopathy, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Painful arm; Swelling of the underarm glands; fever chills; Swelling of the underarm glands; This regulatory authority case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Painful arm), ADVERSE DRUG REACTION (Swelling of the underarm glands) and PYREXIA (fever chills) in a 37-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. Lot 3002332) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. In June 2021, the patient experienced PAIN IN EXTREMITY (Painful arm) (seriousness criterion medically significant), ADVERSE DRUG REACTION (Swelling of the underarm glands) (seriousness criterion medically significant), PYREXIA (fever chills) (seriousness criterion medically significant) and LYMPHADENOPATHY (Swelling of the underarm glands). On 04-Jun-2021, PAIN IN EXTREMITY (Painful arm) and PYREXIA (fever chills) had resolved. At the time of the report, ADVERSE DRUG REACTION (Swelling of the underarm glands) and LYMPHADENOPATHY (Swelling of the underarm glands) was resolving. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not reported. The reporter stated that no treatment medication was taken for pain or swelling reduction. The flu/fever type symptoms (chills) lasted three days and the worst day was 24 hours after the vaccine was given. The patient has not tested positive for COVID-19 since receiving the vaccine. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


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