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

This is VAERS ID 1423518



Case Details

VAERS ID: 1423518 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-06-04
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020821A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Asthma, herniated disc (L5)
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Acutely Migraines, Prolonged Headaches, 5/4/2021 Until present (6/24/2021)


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1423518


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