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

This is VAERS ID 1424327



Case Details

VAERS ID: 1424327 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Headache, Neck pain, Pain in jaw, Tinnitus, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular disorders (narrow), Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benazepril 40MG, Amlodipine Besylate 5MG, Alegra 24hr allergy
Current Illness: none
Preexisting Conditions: Asthma and allergies
Allergies: none
Diagnostic Lab Data: Hearing test done on June 23rd 2021 confirms loss of hearing in right ear.
CDC Split Type:

Write-up: Vertigo, Ringing in Right ear, loss or muffled sound in right ear, headaches, jaw soreness right side, neck pain right side


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1424327


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