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

This is VAERS ID 1404386



Case Details

VAERS ID: 1404386 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002332 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Hypoaesthesia, Limb discomfort, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), COVID-19 (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Patient has not had symptoms associated with COVID-19
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Bruising; Arm discomfort; Numbness of upper arm; This regulatory authority case was reported by a consumer and describes the occurrence of CONTUSION (Bruising), LIMB DISCOMFORT (Arm discomfort) and HYPOAESTHESIA (Numbness of upper arm) in a 31-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002332) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 03-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 CONTUSION (Bruising) (seriousness criterion medically significant), LIMB DISCOMFORT (Arm discomfort) (seriousness criterion medically significant) and HYPOAESTHESIA (Numbness of upper arm) (seriousness criterion medically significant). At the time of the report, CONTUSION (Bruising) and LIMB DISCOMFORT (Arm discomfort) had not resolved and HYPOAESTHESIA (Numbness of upper arm) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: covid-19 virus test-19 test (Negative) Patient has not had symptoms associated with COVID-19. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant medication information was mentioned.Patient has not had symptoms associated with COVID-19. Patient was not enrolled in clinical trial and was not breastfeeding No treatment medication information was mentioned For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown), the reporter did not provide any causality assessments. Company Comment 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.; 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.


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