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

This is VAERS ID 1430507



Case Details

VAERS ID: 1430507 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Guam  
Vaccinated:2021-05-18
Onset:2021-06-26
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Pain, Sneezing
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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: L Arginine, L Carnitine, Vitamin E Vitamin D3 Benadryl Ibuprofen
Current Illness:
Preexisting Conditions: PTSD Fatigue
Allergies: Bell pepper Hay fever
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Allergy sneezing with body pain. arms L and R, across chest right side of face and neck


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430507


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