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

This is VAERS ID 1423404



Case Details

VAERS ID: 1423404 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-06-09
Onset:2021-06-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pain, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Losartan 50 MG Metoprolol 50 gm Aspirin 81 MG Multivitamins Calcium
Current Illness: N/A
Preexisting Conditions: Elevated blood pressure
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: First I felt swelling and pain. Currently, I have the arm area red and swollen, I also feel itching in the area.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1423404


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