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

This is VAERS ID 1416072



Case Details

VAERS ID: 1416072 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002332 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Pain in extremity, SARS-CoV-2 test, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: PARACETAMOL
Current Illness: Joint pain
Preexisting Conditions: Medical History/Concurrent Conditions: Pregnancy; Comments: Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Date: 20210512; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: joint pain; sleepy; Pain in arm; Joint ache; Headache; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of SOMNOLENCE (sleepy), PAIN IN EXTREMITY (Pain in arm), ARTHRALGIA (joint pain), ARTHRALGIA (Joint ache) and HEADACHE (Headache) in a 31-year-old male 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. Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial. The patient''s past medical history included Joint pain, Pregnancy, Joint pain and Pregnancy. Concomitant products included PARACETAMOL from 02-May-2021 to 05-May-2021 for Cold. On 04-Jun-2021, the patient received dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) Dose 1. On 04-Jun-2021, the patient experienced FATIGUE (Fatigue). On 05-Jun-2021, the patient experienced ARTHRALGIA (Joint ache) and HEADACHE (Headache). On 07-Jun-2021, the patient experienced PAIN IN EXTREMITY (Pain in arm). On an unknown date, the patient experienced SOMNOLENCE (sleepy) and ARTHRALGIA (joint pain). On 07-Jun-2021, ARTHRALGIA (Joint ache), HEADACHE (Headache) and FATIGUE (Fatigue) had resolved. At the time of the report, SOMNOLENCE (sleepy) and ARTHRALGIA (joint pain) outcome was unknown and PAIN IN EXTREMITY (Pain in arm) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-May-2021, SARS-CoV-2 test: no - negative covid-19 test Negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown Route) was unknown. Had really bad joint pain. Making it difficult to move from Saturday evening until mid afternoon Sunday when it start going away. Also felt very sleepy and had regular headaches. Arm ached and was very painful whenever someone touched it. Patient has not tested positive for COVID-19 since having the vaccine Adverse reaction did not occur as a result of an exposure during pregnancy; 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. The event was classified as serious by the regulatory authority. However, there is no apparent rationale to deal it as serious.


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