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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1430280



Case Details

VAERS ID: 1430280 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-26
Onset:2021-06-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Feeling hot, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient describes wide spread tingling and warm sensation in upper body stretching to the face as well as both arms. She reports no fever but is unable to tell if any erythema as she is African American. She said it started late last night and has not changed since that time. She said it felt like she had been out in the sun all day but also the skin was tingling. Since she described tingling skin and warm sensation I had advised her to be checked for possible allergic reaction. Pt was going to go to urgent care to get checked out. Pt did report also suffering from anxiety during telephone call and was not sure it it could have contributed to the situation.


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